Illinois Licensed Medical Director

Job Summary

A company is looking for a Medical Director - Medicaid (IL).

Key Responsibilities

• Oversee Utilization Management, including prior authorization and concurrent review for inpatient and outpatient services
• Ensure timely responses to members and providers regarding precertification, concurrent review, and appeal requests
• Participate in a rotating on-call schedule for weekend and holiday coverage

Required Qualifications

• Five or more years of experience providing direct patient care
• Illinois state medical license without encumbrances
• M.D. or D.O. with current and active board certification in an ABMS or AOA recognized specialty
• Board certification in Family Medicine or Internal Medicine/Pediatrics
• Prior Utilization Management experience at a health plan or as a Physician Advisor is a plus