Responsible for medical policy development and oversight as it relates to utilization review. Review data analytics as generated by medical policies and formulate strategies to address over/under utilization, best practices, and cost containment.
Develop professional relationships and communicate with national and regional thought leaders to ensure access to medical and scientific information on Merck products and areas of therapeutic interest.
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
The Director of Medical Staff Services provides guidance, direction and leadership in all areas of Medical Staff Services support, system credentials process, and to the Medical Directors and Medical Staff Leadership in a hospital.