Maine Licensed Medical Director

Job Summary

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

Key Responsibilities

• Provide clinical leadership and direction for utilization and care management functions
• Perform medical necessity reviews and contribute to case reviews for quality and safety of care
• Assist in the development of annual program descriptions and participate in medical policy review

Required Qualifications, Training, and Education

• Board certified physician with post-graduate experience in direct patient care
• Medical leadership experience in a Health Plan is preferred
• Knowledge of process improvement tools and experience in Health Plan utilization management
• Active and unrestricted medical license in Maine or New Hampshire, or eligibility for licensure in another U.S. state
• Current or ability to have active clinical work with patients