Pennsylvania Licensed Medical Director

Job Summary

Leading clinical strategy and utilization management, the full-time remote Pennsylvania Licensed Medical Director will perform utilization reviews, support various committees, and advise senior management on effective healthcare service delivery.

Key responsibilities

• Conduct utilization reviews for various service requests, including inpatient and outpatient care
• Advise on healthcare service utilization and participate in disease and care management rounds
• Develop and implement policies and guidelines to enhance utilization management and quality targets

Required qualifications

• Medical Physician (MD or DO) with an unrestricted Pennsylvania Medical License
• Board Certification in a specialty, preferably primary care
• Minimum 5 years of post-residency experience in clinical practice
• Experience in managed care with a focus on utilization management
• Graduate business degree (MBA or similar) is a plus