Associate Medical Director - Utilization Review - Remote

Overview

The Associate Medical Director leverages their medical experience and judgment to determine whether requested services, levels of care, and/or sites of service should be authorized, operating within a framework of criteria from the patient’s healthcare plan and regulatory compliance.

In Short

• Leverage medical experience for service authorization decisions.
• Conduct peer-to-peer phone calls for case determinations.
• Support internal workflows and collaborate across teams.
• Ensure adherence to national guidelines and regulations.
• Work a structured schedule including weekend shifts.
• Manage in-patient co-morbidities effectively.
• Demonstrate integrity and professionalism.
• Utilize resources to make informed decisions.
• Work independently with minimal supervision after training.
• Meet departmental expectations and compliance timelines.

Requirements

• MD or DO degree with board certification in Family Medicine or Internal Medicine.
• 5 years of recent direct patient care experience, including 3 years in an acute care setting.
• Strong computer literacy and adeptness with technology.
• Willingness to obtain multiple state licenses.
• Clean background without licensure issues.
• Must pass USMLE or equivalent exam components in no more than three attempts.
• Full commitment to scheduled work hours.
• Must reside and work within the United States.

Benefits

• Support for obtaining additional state licenses.
• Opportunity to work in a structured environment.
• Collaboration with a dedicated team.
• Engagement in compliance and clinical best practices.
• Professional development opportunities.