Ohio Licensed Assistant Medical Director

Providing clinical expertise to enhance the delivery of high-quality, cost-effective medical care, the full-time Ohio Licensed Assistant Medical Director will support utilization review processes, conduct pre-determination reviews, and ensure compliance with clinical goals in a remote setting. Key responsibilities Oversee the utilization review process and ensure appropriate medical care is received Conduct pre-determination reviews and provide clinical expertise for claims determinations Guide the case management team in coordinating quality care and monitor care management performance Required qualifications Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited medical school Minimum of 5 years of established clinical care practice experience Board Certification in a nationally recognized specialty (ABMS or AOA) is required Active unrestricted license to practice medicine in the state of residency Knowledge of health plan claims adjudication and utilization review processes preferred