California Licensed Medical Director
Job Summary
To support the growing Prior Authorization program in California, the remote California Licensed Medical Director will manage prior authorization for Medicare Advantage members, focusing on high-value procedures, while promoting evidence-based medicine and improving patient care quality.
Key responsibilities:
- Improve quality and promote evidence-based medicine through utilization management and claims review
- Provide information on quality and efficiency to inform care choices for doctors, patients, and customers
- Collaborate with medical director teams on inpatient care management and clinical reviews
Required qualifications:
- MD or DO degree
- Active, unrestricted physician state license in California
- Current board certification through ABMS or AOA
- 5+ years of clinical practice experience post-residency
- Solid understanding of evidence-based medicine and managed care principles
Complete Job Description
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