Pennsylvania Licensed Medical Director
Job Summary
To support specialized cases for Community Health Choices, the full-time Pennsylvania Licensed Medical Director will oversee quality and utilization standards, provide leadership in credentialing and quality improvement, and ensure effective communication with network providers in a remote setting.
Key responsibilities
- Provide leadership direction for provider credentialing processes and ensure timely medical decisions
- Actively participate in utilization management and quality improvement review processes, including member grievances and provider appeals
- Communicate and educate network providers on clinical guidelines, pathways, and standards related to quality and utilization processes
Required qualifications
- Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) required
- Current unrestricted Pennsylvania medical license or ability to obtain prior to hire
- Board Certified in Family Medicine, Internal Medicine, Emergency Medicine, or Geriatrics
- At least five (5) years of clinical experience
- Act 34 clearance required
Complete Job Description
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