Medical Director
Confidential
Medical Director
About the Company
Healthcare managed care organization providing clinical oversight for utilization management.
Industry
Insurance
Type
Privately Held
About the Role
The Company is seeking a Medical Director with an MD or DO from an accredited medical school to provide clinical leadership and oversight for physical health utilization management. The successful candidate will be responsible for ensuring high-quality, compliant, and defensible medical review decisions, and will work closely with medical, behavioral health, and care management teams. This role is pivotal in supporting clinical quality initiatives, regulatory compliance, and operational excellence across utilization management functions. Applicants must have a minimum of 2 years' of managed care and utilization management experience, and hold a Board Certification in Family Medicine or Internal Medicine, as well as an active, unrestricted medical license in North Carolina. The Medical Director will be involved in reviewing and authorizing physical health services and levels of care, conducting various types of utilization management reviews, and providing clinical guidance and leadership to the relevant teams. Collaboration across departments to address complex cases and improve care delivery processes is also a key aspect of the role. The position is full-time, primarily remote, and may require occasional evening, weekend, or holiday work.
Functions
- Medical Care/Hospital Administration
Vacancy posted 2 days ago
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