PRN/Weekends- Saturdays/Sundays This PRN Associate Medical Director provides support for Community Health Choice?s medical management programs. This includes performing medical necessity reviews, with peer to peer interactions as needed; appeals of adverse determinations; QUALIFICATIONS: M.D. or D.O. Degree and Licensure in the State of Texas, Completion of Residency and Board Certification with preference for the Primary Care Specialties Two years prior managed care experience, to include proficiency in performing medical necessity reviews, benefit coverage reviews, and reviews of appeals of adverse determinations; Experience with STAR, CHIP and Health Insurance Marketplace programs preferred; Three
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