Pennsylvania Licensed Medical Director

Job Summary

A company is looking for a Medical Director to provide physician leadership supporting medical decision-making across health plan operations.

Key Responsibilities of the Medical Director:

• Provide physician leadership for utilization and care management activities
• Apply evidence-based clinical guidelines to evaluate medical necessity and quality
• Collaborate with clinical teams and external partners to promote patient-centered care

Qualifications and Skills for the Medical Director:

• Medical Doctor (MD) or Doctor of Osteopathy (DO) from an accredited institution
• Active, unrestricted Pennsylvania medical license
• Current board certification through ABMS or AOBMS; family or internal medicine preferred
• Strong clinical judgment in utilization management and health insurance frameworks
• Ability to complete required credentialing processes