State Licensed Medical Director

Job Summary

Supporting the medical management team, the remote hourly Associate Medical Director will conduct clinical case reviews, perform physician outreach for medical necessity determinations, and manage grievances and appeals within their specialty scope.

Key Responsibilities

• Complete timely clinical case reviews within board-certified specialty
• Make physician-to-physician calls to obtain clinically relevant information for medical necessity decisions
• Review requests for outpatient physical therapy, occupational therapy, and speech therapy services

Required Qualifications

• MD or DO degree
• Board certification from an approved certifying board, where applicable to job duties
• Active, unrestricted medical license to practice medicine or health profession in the applicable jurisdiction
• Experience with medical case review and utilization review preferred
• Exposure to outpatient PT, OT, and ST review strongly preferred