Ohio Licensed Medical Director

Job Summary

Providing leadership to utilization management teams, the full-time Ohio Licensed Medical Director will oversee physician review processes, participate in quality improvement initiatives, and ensure compliance with clinical goals in a hybrid work environment.

Key responsibilities:

• Oversee the physician's utilization review process and determinations
• Participate in quality processes such as audits and quality improvement projects
• Provide leadership support to assistant medical directors and coordinate quality care

Required qualifications:

• MD or DO from an accredited medical school with an active, unrestricted license to practice medicine in the United States
• Minimum of 5 years of established clinical care practice experience
• Board Certification in a nationally recognized specialty (ABMS or AOA) is required
• Physician reviewer experience in the insurance industry preferred
• Strong understanding of evidence-based medicine and managed care principles