California Licensed Medical Director

Job Summary

A company is looking for a Medical Director (West) to oversee medical policy implementation and support medical management programs.

Key Responsibilities

• Provide oversight for medical policy implementation and clinical program development
• Support Medical Management staff and ensure timely responses to members and providers
• Oversee utilization review, quality assurance, and predetermination reviews

Required Qualifications

• Active and current state medical license in the Pacific Time Zone
• M.D. or D.O. with Board Certification in an ABMS or AOA recognized specialty
• Post-graduate direct patient care experience
• Previous utilization management experience with a Health Plan/Payor is preferred