Texas Licensed Medical Director
Job Summary
To support clinical utilization management programs, the part-time Texas Licensed Medical Director will manage medication utilization reviews and appeals, provide consultative support, and communicate with prescribers, all while working remotely from 5 PM to 9 PM CT.
Key responsibilities:
- Complete medication utilization reviews and medical necessity appeals for various clients
- Make clinical determinations based on medical necessity criteria and scientific literature evaluations
- Provide peer-to-peer support to physicians regarding clinical programs and utilization review decisions
Required qualifications:
- Graduate of an accredited Medical School and Residency Program
- Active Texas medical license with no history of disciplinary actions
- A minimum of 5 years of clinical practice with direct patient care, specializing in Internal Medicine
- Board certification by the appropriate Medical Board (DO, MD)
- Experience in clinical outcomes and knowledge of medical statistics and regulatory agencies
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