Florida Licensed Medical Director

Job Summary

To enhance Utilization Management and Care Management processes, the fully remote Florida Licensed Medical Director will provide clinical support, educate medical staff on best practices, and serve as a liaison among various stakeholders to improve patient care quality and documentation.

Key responsibilities

• Provides clinical support and validation for Utilization Management (UM) and Care Management (CM)
• Educates medical staff on UM/CM best practices and clinical guidelines
• Guides UM staff on authorizations, concurrent review, denials, and medical necessity criteria

Required qualifications

• Doctorate in a relevant field
• Successful history as a practicing physician
• Payor experience in operations
• Experience in a physician group model
• Demonstrated ability to build and sustain relationships in the medical community and corporate environment