Pennsylvania Licensed Medical Director
VirtualVocations
To support the Utilization Management team, the full-time Pennsylvania Licensed Medical Director will oversee adherence to quality and utilization standards, ensure comprehensive healthcare delivery to members, and lead provider credentialing processes in a fully remote capacity. Key responsibilities Provide leadership direction for provider credentialing processes and ensure timely medical decisions Participate in utilization management and quality improvement reviews, addressing member grievances and provider appeals Communicate clinical guidelines and standards to network providers while supporting Quality Improvement and Care Management goals Required qualifications Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited school Minimum of 5-10 years of clinical experience Managed Care experience preferred Board certification in Internal Medicine, Family Medicine, Geriatric Medicine, or Emergency Medicine is preferred Valid Pennsylvania Medical License
Vacancy posted 6 days ago
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