Medical Director Utilization Management

Direct message the job poster from The Judge Group Medical Director – National Utilization Management Team (One Weekend per Month) Location: Remote (U.S. only; must reside in the U.S.) Pay Rate: $120/hour Start Date: ASAP Schedule: 40 hours per week with rotating weekend coverage; participation in weekend work on a rotational basis to ensure cases are decisioned in a timely manner Type of engagement: W2 ongoing contract 6+ months/ with potential for conversion to full-time/ perm based on performance Reports To: Lead Medical Director Summary: In this role, you will review medical records, analyze complex clinical scenarios, and make expert determinations on requested services. You will collaborate with external providers via phone to gather additional clinical information and discuss decisions. This position requires strong integrity, professionalism, and the ability to thrive in a team-oriented environment. The position requires availability for one weekend per month . Key Responsibilities Conduct timely and compliant medical necessity reviews for inpatient services Ensure services align with national guidelines, CMS requirements, company policies, and clinical standards Communicate determinations clearly, both verbally and in writing Maintain accountability for productivity, quality, and compliance metrics Adapt to evolving workflows, tools, and utilization management practices Required Qualifications MD or DO degree Minimum 5 years of direct clinical patient care experience post-residency or fellowship (preferably inpatient or Medicare population) Current and ongoing ABMS Board Certification Active, unrestricted medical license in at least one U.S. state; willingness to obtain additional licenses if needed No sanctions from federal or state agencies; able to pass credentialing requirements Strong verbal and written communication skills Proven analytical and interpretation skills; team-oriented experience Preferred Qualifications Knowledge of managed care (Medicare Advantage, Managed Medicaid, Commercial products) Utilization management experience in medical review organizations Familiarity with national guidelines (MCG®, InterQual) Hospital-based clinical experience (Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine) Ability to adapt to change and leverage technology for workflow improvements Commitment to innovation and organizational goals Experience in educational activities (teaching, presenting, content creation) Interview Process One interview with Lead Medical Director before final decision Schedule Full-time position with one weekend per month on-call or coverage responsibilities Seniority Level Associate Employment Type Contract Job Function Health Care Provider Industries Hospitals and Health Care #J-18808-Ljbffr