Medical Director – Utilization Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct utilization management case evaluations.

• Adhere to productivity standards set by the company.

• Meet annual quality benchmarks as per company guidelines.

• Complete annual inter-rater reliability assessments.

• Provide training across all queues as requested by MRIoA leadership.

• Fulfill all client-specific training requirements as requested by MRIoA leadership.

• Keep accurate and current records of case completions when necessary.

• Show a consistent willingness to accept cases when asked.

• Exhibit respect in all interactions throughout the company.

• Submit scheduling requests at least three months in advance consistently.

• Adhere to the scheduled hours consistently.

• Offer suggestions for the promotion and growth of the company as requested (i.e., contribute to the company's vision).

• Respond promptly and appropriately to licensing/CME inquiries from the Senior Medical Directors, Vice President of Medical Affairs, or Chief Medical Officer and/or administrative team.

• Actively engage in the MRIoA evaluation process (both at the company and individual levels).

• Attend all company meetings and participate in committees as requested.

• Undertake additional responsibilities as requested or approved by the CEO and/or chief medical officer.

• Possess a thorough understanding of the company’s clients, products, departments, workflows, and relevant regulatory requirements and accreditation standards.

⛳️ Requirements

• Minimum of five years of full-time equivalent experience providing direct clinical care to patients.

• At least five years of experience in administering utilization management and peer review programs is preferred.

• Credentialed and privileged by the Company's Credentialing Committee.

• Acquire additional state licensure as required for the role.

• Education: MD/DO degree.

• Hold a current, unrestricted medical license as mandated for clinical practice in a state of the United States.

• Board certification by a medical specialty board recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA), or other board acknowledged by URAC is preferred.

🏝️ Benefits

• Healthcare, vision, and dental insurance.

• A generous 401(k) match.

• Paid vacation, PTO, and holidays.

• Opportunities for growth and training.

• An award-winning remote work environment.