Florida Licensed Medical Director

Job Summary

A company is looking for a Medical Director Care Management.

Key Responsibilities:

• Perform all types of utilization management (UM) reviews, including Pre-service, Post-service, Concurrent Review, and Appeals
• Discuss cases with physician providers (Peer to Peer) and collaborate with Case Managers for support and guidance
• Meet established metrics related to UM review efficiency, participate in audits, and assist staff in understanding clinical concepts

Required Qualifications:

• Current unrestricted Florida medical license as a Doctor of Medicine or Doctor of Osteopathic Medicine
• Board Certification or Board eligibility by American Board of Medical Specialties or equivalent
• Utilization management experience
• 5+ years of clinical experience
• Experience working both independently and in a team environment