Part-Time Weekend Medical Director - Remote

Overview

The Part-Time Weekend Medical Director will be responsible for ensuring that utilization management responsibilities are performed in accordance with the highest clinical standards, reviewing escalated cases, and participating in multidisciplinary teams.

In Short

• Conduct electronic reviews of escalated cases against medical policy criteria.
• Participate in telephonic peer discussions as required.
• Ensure compliance with NCQA, URAC, CMS, DOH, and DOL regulations.
• Advise multidisciplinary teams on high-risk cases.
• Participate in protocol and guidelines development.
• Manage projects requiring a physician subject matter expert.
• Compose clear rationales for member and provider notifications.
• Attend huddles and grand rounds.
• Maintain community standards of care in medical management.
• Other duties as assigned.

Requirements

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) required.
• 5 years of clinical direct patient care experience required.
• 1 year of medical management experience preferred.
• Board certification in a recognized specialty required.
• Active medical state licensure required.
• Strong knowledge of the managed care industry preferred.
• Excellent critical thinking and communication skills.
• Ability to collaborate and manage projects effectively.

Benefits

• Competitive salary range from $170,000 to $342,274 per year.
• Flexible working hours.
• Opportunity to work remotely.
• Engagement in multidisciplinary team settings.
• Professional development opportunities.
• Supportive work environment.
• Comprehensive health benefits.
• Contributions to community health initiatives.
• Access to resources for continuous learning.
• Commitment to diversity and inclusion in the workplace.