For our client, we are seeking a Medical Director (medicare) to join the team of a leader in the Healthcare space. This role will lead technical initiatives focused on scalable systems, platform reliability, and meaningful business transformation. You will work across engineering, product, operations, and business stakeholders to translate complex requirements into practical technology solutions. The position offers the opportunity to influence architecture, execution quality, and the technology capabilities that enable long-term growth within a healthcare environment.
Location: Remote - US based candidates only, no visa sponsorship available
Compensation: $150,000 – $200,000 annually
Responsibilities
- Evaluate appropriateness and necessity of healthcare services for members
- Support and implement the utilization management program
- Monitor and assess utilization management practices
- Educate providers on best practices and guidelines
- Lead and supervise adherence to medical necessity criteria
- Participate in quality assurance and accreditation processes
- Review and resolve medical quality grievances and appeal cases
Qualifications
- 3+ years of healthcare experience, 2 in medical practice or related education/experience
- Active MD or DO license in practicing state
- Board certification required
- Knowledge of healthcare regulations and laws
- Ability to collaborate in a matrixed organization
- Strong organizational and time management skills
- Proficient in Microsoft Office and other relevant software
Benefits
- Comprehensive health insurance options
- Retirement savings plan with employer contributions
- Continuing education and professional development support
- Paid time off and flexible scheduling
- Employee wellness programs and resources
Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs.
