State Licensed Medical Director

Job Summary

Offering a part-time contractor position, the State Licensed Medical Director will perform clinical reviews, participate in inter-rater reliability activities, and serve as a clinical resource for staff in a fully remote environment.

Key responsibilities

• Perform clinical reviews, including Part A, B, appeals, and quality of care, while conducting peer-to-peer discussions
• Participate in inter-rater reliability activities to ensure consistent clinical decision-making
• Act as a clinical resource and subject matter expert for both clinical and non-clinical staff

Required qualifications

• Broad state licensure coverage
• Experience in Medicare Utilization Management
• Willingness to obtain additional state licenses as needed
• Comfort with learning and adapting to new technologies