North Carolina Licensed Medical Director

Job Summary

To provide clinical oversight and operational support for physical health services, the full-time North Carolina Licensed Medical Director will manage medical review processes, ensure quality utilization management, and collaborate with clinical teams, primarily working remotely with occasional on-site requirements.

Key responsibilities

• Provide expert guidance for physical health service requests and ensure quality in utilization management activities
• Apply medical necessity criteria for service authorization and complete required case volume efficiently
• Support clinical operations through participation in committees and provide clinical leadership to enhance collaboration among teams

Required qualifications

• M.D. or D.O. degree from an accredited medical school with board certification in a relevant field
• At least four years of postgraduate clinical experience
• A minimum of two years of managed care and utilization management experience
• Current, active, and unrestricted medical license in North Carolina or qualifications to obtain one
• Knowledge of managed care principles and recent developments in the field of medicine