DC and MD Licensed Medical Director

Job Summary

A company is looking for a Health Plan Medical Director Physician.

Key Responsibilities

• Oversee daily operations of case management, disease management, and utilization review
• Conduct reviews of inpatients, precertification requests, and emergency department visits
• Ensure utilization review decisions align with medical necessity and coverage criteria

Required Qualifications

• 5 years of clinical experience with progressive leadership roles
• Preferred experience in health plan operations
• Must reside in the DC/Maryland area
• Medical licensing in DC and Maryland is required
• Experience in telehealth is a plus