State Licensed Medical Director

Job Summary

Supporting clinical operations in a remote capacity, the full-time State Licensed Medical Director will manage care management, quality, and utilization management activities while participating in case reviews and committee functions.

Key responsibilities

• Completes care management and appeal case reviews for medical necessity, ensuring adherence to policies and clinical guidelines
• Participates in quality of care complaint reviews and collaborates on initiatives to improve service at the point of care
• Chairs the Technology Assessment Committee and serves as clinical representation on various committees

Required qualifications

• Medical Doctorate (MD) or Doctor of Osteopathic Medicine (DO)
• 10+ years of experience beyond degree
• 5+ years of leadership experience
• Current medical license to practice without restrictions
• Current Board certification in an ABMS recognized specialty