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About Michigan Department of Health and Human Services

Medical Consultant (prior authorization reviews; part time)

Job Code Number

346276312

Job Description

The Medical Consultant serves in the Office of Medical Affairs, which is housed in
MDHHS Health Services and provides clinical support to Michigan Medicaid.

Utilizing clinical expertise and knowledge of program policies, the Medical Consultant performs prior authorization reviews for Michigan Medicaid. This work is accomplished through review of clinical and administrative documentation to inform decisions in response to requests for coverage of pharmaceuticals under the pharmacy benefit. This work may also include similar reviews for clinical services, procedures, pharmaceuticals, supplies, and/or equipment requested under the medical benefit. This position may participate in administrative appeal hearings for prior authorization cases when necessary. Depending on programmatic needs, this position may also provide clinical consultation for other tasks in the Office of Medical Affairs.

Additional Requirements

• Possession of a medical degree from an accredited school of medicine

• At least three years of post-medical degree, full-licensure experience in the practice of
medicine or osteopathic medicine and surgery

• Successful completion of medical residency training

• Current possession of an unrestricted and non-contested Michigan license to practice
medicine or osteopathic medicine and surgery

Preferred experience: Full-licensure experience (post-medical degree and residency) in providing medical care to adults

Organization Profile

Employer Name:

Michigan Department of Health and Human Services

Address:

235 S. Grand Ave

Address Line 2:

City:

Lansing

State/Province/Region:

Zip/Postal Code:

48933

Description:

The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect and fairness. For more information, please visit our MDHHS Diversity, Equity, and Inclusion Plan.

Job Summary

Organization

Michigan Department of Health and Human Services View Profile

Employer Website

Location

Lansing, Michigan 48933

Job Code Number

346276312

Positions Available

Expiration Date

2/11/2026

O*NET Code

29-2072.00

O*NET Occupation

Education Level

Masters Degree or above

Job Characteristics

Part-time

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Job Details

Medical Consultant (prior authorization reviews; part time)

Organization Profile

Job Summary

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