North Carolina Licensed Medical Director

Job Summary

To provide clinical leadership and oversight, the full-time North Carolina Licensed Medical Director will manage utilization review processes and ensure compliance with regulatory standards while working primarily remotely.

Key Responsibilities

• Review and evaluate requests for physical health services, ensuring appropriate utilization and compliance with medical necessity criteria
• Participate in organizational committees and provide clinical consultation to multidisciplinary teams to enhance operational efficiency
• Train and mentor Medical Management team members, supporting the onboarding and development of new Physical Health Medical Directors

Required Qualifications

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited medical school
• Minimum of 4 years of post-graduate clinical practice experience
• Minimum of 2 years of managed care, utilization management, or medical review experience
• Current, active, unrestricted North Carolina medical license, or eligibility to obtain North Carolina licensure
• Board Certification in an applicable specialty, such as Family Medicine or Internal Medicine