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