State Licensed Medical Director

Job Summary

A company is looking for a Utilization Review Medical Director (Remote).

Key Responsibilities

• Conduct coverage reviews using critical thinking and clinical expertise based on patient benefits and coverage policies
• Interpret benefit language and policies to guide clinical coverage determinations
• Document clinical review findings and engage in peer-to-peer consultations with prescribing providers

Required Qualifications

• Active, unencumbered state licensure as a Medical Doctor (MD/DO)
• Current board certification in Family Medicine or Internal Medicine
• Minimum of 5 years of direct patient care experience, with recent experience within the last 6 months
• Willingness to obtain up to 20 additional state licenses
• Clean background without prior licensure issues or legal problems