Associate Medical Director – UM PT

This is a fully remote position, open to applicants in Florida, +4 more states.

📋 Description

• Accountable for aiding the Medical Director in the supervision of Utilization Management (UM) programs.

• Assist in the creation and ongoing management of these programs, emphasizing clinical precision and suitability.

• Support the Medical Director in formulating strategic corporate objectives for UM programs.

• Aid the SVP, Healthcare Services in compiling annual performance metrics for UM programs.

• Contribute to quantifiable results for prior authorization, step therapy, and quantity limit initiatives.

• Collaborate with internal teams to enhance corporate HEDIS initiatives through the appropriate development of clinical programs.

• Work closely with teams focused on clinical program development, clinical service operations, and clinical quality committees.

• Offer clinical guidance and oversight in these areas.

• Participate in IH committees as directed by the Medical Director.

⛳️ Requirements

• A graduate degree from an accredited medical school and completion of a residency program is required.

• A master’s degree in healthcare administration, business, or public health is preferred.

• Must hold an unrestricted, current, and active medical license issued by the NY State Board of Licensure or the State Board of Osteopathic Examiners.

• Must be a member in good standing within the medical community.

• Board certification in a recognized medical specialty as acknowledged by the American Board of Medical Specialists (ABMS) is preferred, ideally in Primary Care (internal medicine, family practice, etc.).

• A minimum of five (5) years of post-graduate clinical experience in healthcare management and utilization review is required; experience in quality assurance and peer review is preferred.

• Experience in private practice is preferred.

• Willingness to participate in the UM call schedule to provide remote coverage during evenings, weekends, and holidays.

• Exceptional verbal, written, and interpersonal communication skills are required.

• Strong computer navigation skills are essential.

• Proven ability to work efficiently as part of a multidisciplinary team.

• Demonstrated capability to analyze, interpret, and communicate the significance of healthcare data.

• Documented examples of embodying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, and Accountable.

🏝️ Benefits

• Comprehensive range of benefits.

• Generous paid time off.

• Scorecard incentive.