Medical Director - 257394

Medix™ • $210k - $269k / year • 18h ago

Medical Director - Utilization Management

Responsibilities

Provide expert guidance and oversight for physical health service requests, including authorization of services and determination of appropriate level of care
Ensure the integrity and quality of utilization management activities, including initial reviews, concurrent reviews, appeals, and level of care determinations for inpatient and outpatient services
Participate in internal reviews of inpatient and outpatient clinical case types to ensure compliance with regulatory, accreditation, and organizational standards
Apply medical necessity criteria utilizing review criteria hierarchy for level of care and services regarding type, amount, and duration of service. Complete expected case volume as expected by the department

Required Qualifications

Medical Degree (MD or DO) from an accredited program.
Current Board Certification in a recognized clinical specialty.
Active, unrestricted medical license in North Carolina

Compensation and Benefits

$210,000 - $269,000+/yr
Fully remote work environment, on-site training in Raleigh, NC.
Comprehensive equipment provided by the client.
Stable 40-hour work week with a flexible schedule (typically 8:30 AM – 5:00 PM EST).

Related Jobs

Medical Science Liaison

TSP, a Syneos Health company • Full-time • Remote • $200k - $230k / year • 18h ago

Pharma msl medical science liaison remote Fulltime

18h ago

Section Head for Thoracic Medical Oncology - Physician - Tisch Cancer Center - Manhattan, NY

Mount Sinai Health System • Full-time • New York, NY • $375k - $475k / year • 18h ago

Other On-site Physician Fulltime Thoracic Medical Oncology

18h ago

Medical Director Utilization Management

Cohere Health • Full-time • Remote (Boston, Massachusetts, United States) • $240k - $250k / year • 18h ago

Utilization Management medical director remote Fulltime

18h ago

Medical Director

CareSource • Full-time • Remote • $195.20k - $341.60k / year • 18h ago

Utilization Management medical director remote Fulltime

18h ago

Medical Director - Florida (3)

Ladders • Full-time • Remote (United States) • $174.07k - $374.92k / year • 18h ago

Utilization Management medical director remote Fulltime

18h ago

Contracting Physician - Board Certified

Eurofins • Full-time • Piscataway, New Jersey, United States • from $200 / hour • 18h ago

Other On-site Board-certified Principal Investigator Pediatrician Fulltime Ophthalmologist Dermatologist Contracting Physician Gynecologist

18h ago

Medical Director

Warwick Consulting • Full-time • Remote (United States) • 18h ago

Other medical director remote Fulltime

18h ago

Medical Science Liaison II - Pacific Northwest, Screening

Guardant Health • Full-time • Wyoming, United States • $164.90k - $226.75k / year • 18h ago

Pharma msl medical science liaison remote Medical Affairs Fulltime Medical Science Liaison II

18h ago

Physician: Clinical Investigator, Head and Neck Oncology Program

Boston Medical Center (BMC) • Full-time • Boston, MA • 18h ago

Other On-site Physician Fulltime Clinical Investigator Head and Neck Oncology Program

18h ago

Medical Director, NY - Multiple Openings (Remote)

EmblemHealth • Full-time • Remote • 3d ago

Utilization Management medical director remote Fulltime

3d ago