State Licensed Medical Director

Job Summary

A company is looking for a Medical Director, Utilization Management.

Key Responsibilities

• Evaluate outpatient referrals and inpatient admissions for medical appropriateness
• Review authorization requests for medical necessity and maintain established timelines
• Mentor UM nurses and support the development of clinical guidelines and policies

Required Qualifications

• MD or DO degree
• Board Certification in Internal Medicine, Family Medicine, Emergency Medicine, or a related specialty
• Valid, unrestricted medical license in a U.S. state
• Minimum of five years of clinical experience
• At least one year of experience as a Utilization Management reviewer