Pennsylvania Licensed Medical Director
Job Summary
To support specialized cases for Community Health Choices, the full-time Pennsylvania Licensed Medical Director will provide leadership in quality improvement and care management, oversee provider credentialing, and ensure adherence to health care standards, all while working remotely with occasional travel to Pittsburgh.
Key responsibilities
- Provide leadership direction for provider credentialing processes and ensure timely medical decisions
- Actively participate in utilization management and quality improvement reviews, including addressing member grievances and provider appeals
- Communicate clinical guidelines and standards to network providers to improve member satisfaction and compliance
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
- Strong computer skills and ability to navigate multiple systems effectively
Complete Job Description
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