State Licensed Medical Director

Job Summary

To lead the innovation and performance of clinical AI initiatives, the remote State Licensed Medical Director will manage the training, testing, and surveillance of clinical AI models, focusing on utilization management and ensuring accurate interpretation of medical policies across enterprise operations.

Key responsibilities:

• Maintain expertise in InterQual criteria and ensure consistent application across services and levels of care
• Lead the development and enhancement of evidence-based UM clinical criteria, ensuring alignment with approved medical policies
• Oversee clinical annotation and analysis teams to support LLM-based UM decision support and ensure model performance

Required qualifications:

• MD or DO with active/unrestricted U.S. Medical Licensure
• Board certification in an ABMS/AOBMS Clinical specialty
• Significant experience in utilization management and clinical operations within large organizations
• Demonstrated experience working with InterQual clinical criteria
• Proven ability to lead across clinical, operational, and technical teams