Physician Medical Director - Competitive Salary

Job Description

We are seeking a Remote Medical Director for a non-clinical role focused on prior authorization and medical necessity reviews. No direct patient care is required. Candidates must reside in the LAarea and be available for occasional on-site meetings and trainings.

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• Review prior authorization requests and determine medical necessity using evidence-based clinical guidelines.
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• Approve, deny, modify, or redirect services as appropriate.
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• Collaborate with nurses, physicians, and care management teams to support high-quality, cost-effective care.
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• Participate in appeals, grievance reviews, retrospective claims reviews, and quality improvement initiatives.
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• Serve as a clinical resource to providers on utilization management and patient care issues.
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• MD or DO degree required.
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• Board Certification in Internal Medicine strongly preferred.
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• Minimum 5 years of clinical experience required.
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• 2+ years of managed care, health plan, or utilization management experience preferred.
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• Strong knowledge of prior authorization processes and medical necessity criteria.
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• Excellent communication, organizational, and decision-making skills.
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• Proficiency with Microsoft Office and remote work technology.
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• Salary: $250,000"$350,000 annually DOE.
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• Comprehensive benefits package including medical, dental, vision, 401(k), paid time off, life insurance, FSA, tuition reimbursement, CME/license reimbursement, and employee assistance programs.
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This is an excellent opportunity to join one of Southern California's fastest-growing physician organizations in a leadership role that supports quality patient care while maintaining work-life balance.