Remote Utilization Management Medical Director

Job Summary

A medical services company is filling a position for a Remote Utilization Management Medical Director.

Candidates will be responsible for the following:

• Supporting Health Services and Physician Services via utilization management activities
• Conducting authorization reviews, appeals, collaboration with requesting physicians, and more
• Participating in hearing process for second level appeals, and completing quality of care reviews for cases

Applicants must meet the following qualifications:

• Medical Doctorate (MD) or Doctor of Osteopathic Medicine (DO)
• 10+ years as clinical provider
• 3+ years of utilization management experience strongly preferred
• Experience in clinical quality or knowledge of UM practices required
• Health plan utilization management preferred