Hematology/Oncology Physician

$275k

Medix

Medical Director, Hematology/Oncology (Utilization Management & Clinical Strategy)
Full-Time Remote (Post-Onboarding) U.S. Licensed MD/DO

A nationally recognized healthcare organization is seeking an experienced Hematology/Oncology physician to serve in a high-impact Medical Director role focused on utilization management, oncology care determinations, and strategic program development. This position offers the opportunity to directly influence oncology treatment decisions, improve patient outcomes, and help shape an evolving in-house oncology management model.

Position Overview:

This physician leader will serve as a key clinical resource, providing expert oversight for oncology-related medical necessity reviews, prior authorizations, appeals, chronic disease management, and case-level determinations. The role combines clinical excellence with payer-side innovation, data-driven strategy, and collaboration across providers, hospitals, and health plan stakeholders.

Key Responsibilities:

Serve as a clinical resource for staff by establishing criteria and protocols for medical treatment inquiries
Review and render determinations on healthcare service and treatment requests, including prior authorizations and denials
Conduct daily case reviews and participate in case-level discussions
Provide clear, timely, and well-documented medical review determinations
Offer clinical consultation and support to nursing and interdisciplinary teams
Perform utilization review and case management support for complex oncology members
Support chronic disease management through phone, messaging, and video platforms
Conduct peer-to-peer discussions regarding clinical determinations as needed
Serve as a medical liaison to physicians, hospitals, and insurance carriers
Review appeals when not the original reviewer
Analyze clinical and operational data to identify opportunities for improved interventions and best practices
Help develop innovative strategies to enhance care quality while reducing external review dependency

Required Qualifications:

Active, unrestricted MD or DO license in any U.S. state
Hematology/Oncology background (Board Certification strongly preferred)
5+ years of clinical oncology experience
Strong expertise in oncology case review, including chemotherapy, dosing, site-of-care, and treatment determinations
Excellent written communication and peer-to-peer discussion skills
Ability to thrive in a dynamic, evolving, and less structured environment

Preferred Qualifications:

Prior Utilization Management experience
Experience with InterQual, MCG, or clinical policy guidelines
Previous health plan, payer-side, or physician advisor experience
Medical Director leadership experience
Background in building internal clinical programs or reducing external review spend

Schedule & Work Environment:

Full-time, 40+ hours/week
Monday Friday standard schedule
Primarily remote after onboarding
East Coast or Central hours preferred
Weekly rounds participation expected
Light travel: initial onboarding onsite + annual Ohio meeting

Compensation & Benefits Highlights:

Approximate Base Salary: $275K
25% Performance Bonus
Potential Sign-On Bonus Flexibility
Remote Flexibility with minimal travel
Strategic leadership visibility with senior clinical executives
Opportunity to shape oncology strategy, virtual care innovation, and cost-of-care initiatives

Why This Role:

This is more than a traditional utilization review position it s an opportunity to directly shape oncology care delivery, influence policy, and help build a modernized internal oncology management program with significant executive exposure. Ideal for a Hem/Onc physician seeking strategic leadership beyond direct patient care.

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Vacancy posted 1 day ago

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