Associate Medical Director - Genetic Testing (Internal and Family Medicine)
Core
Ensure timely and consistent medical decisions for members and providers by reviewing clinical cases and making medical necessity determinations for services, grievances, and appeals.
Role type
Associate Medical Director (Clinical Operations)
Builds
Medical necessity determinations and clinical case reviews for genetic testing services
Domain
Healthcare / Genetic Testing / Insurance Utilization Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Board certification in Internal or Family Medicine, Active unrestricted medical license, Clinical case review, Physician-to-physician communication, Medical policy interpretation
Preferred skills
Board certification in Family or Internal Medicine
Responsibilities
Review clinical cases for board-certified specialty, Make medical necessity determinations for grievances and appeals, Ensure consistent application of medical policies, Escalate complex cases requiring Medical Director review
Seniority
Senior, hands-on IC
