Medical Director Orthopedic Surgery

The role

Physicians with expertise in Orthopedic Surgery will deliver musculoskeletal and orthopedic programs. You will determine the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines.

What you will do

• Provide timely medical reviews that meet quality parameters
• Provide clinical determinations based on evidence-based criteria
• Document all communication and decision-making in workflow tools
• Use correct templates for documenting decisions during case review
• Meet appropriate turn-around times for clinical reviews
• Conduct timely peer-to-peer discussions with treating providers
• Demonstrate professionalism, accountability, and service
• Support projects to build clinical expertise and efficiency
• Support team on operational improvements

Required qualifications

• Completed US-based residency program in Orthopedic Surgery
• Board certification by appropriate specialty board as an MD or DO
• Current unrestricted state license to practice medicine
• 5+ years of clinical practice beyond residency/fellowship

Nice to have

• 1+ years of managed care utilization review experience
• Membership in national and/or regional specialty societies
• Licensure in AZ, FL, MN, ND, OR, or TX

Benefits

• Medical, dental, vision, life, disability insurance, and Employee Assistance Program
• 401K retirement plan with company match
• Flexible spending and health savings account
• Flex Time Off
• Company holidays
• Up to 14 weeks of paid parental leave
• Pet insurance

Before you apply

• Preliminary Phone Screening
• Meet Hiring Manager
• Behavioral Interview(s)

About the company

Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care. The company works with over 660,000 providers and handles over 12 million prior authorization requests annually.