Hematology/Oncology Physician

Medical Director, Hematology/Oncology (Utilization Management & Clinical Strategy)Full-Time Remote (Post-Onboarding) U.S. Licensed MD/DOA nationally recognized healthcare organization is seeking an experienced Hematology/Oncology physician to serve in a high-impact Medical Director role focused on utilization management, oncology care determinations, and strategic program development. This position offers the opportunity to directly influence oncology treatment decisions, improve patient outcomes, and help shape an evolving in-house oncology management model. Position Overview: This physician leader will serve as a key clinical resource, providing expert oversight for oncology-related medical necessity reviews, prior authorizations, appeals, chronic disease management, and case-level determinations. The role combines clinical excellence with payer-side innovation, data-driven strategy, and collaboration across providers, hospitals, and health plan stakeholders. Key Responsibilities: Serve as a clinical resource for staff by establishing criteria and protocols for medical treatment inquiriesReview and render determinations on healthcare service and treatment requests, including prior authorizations and denialsConduct daily case reviews and participate in case-level discussionsProvide clear, timely, and well-documented medical review determinationsOffer clinical consultation and support to nursing and interdisciplinary teamsPerform utilization review and case management support for complex oncology membersSupport chronic disease management through phone, messaging, and video platformsConduct peer-to-peer discussions regarding clinical determinations as neededServe as a medical liaison to physicians, hospitals, and insurance carriersReview appeals when not the original reviewerAnalyze clinical and operational data to identify opportunities for improved interventions and best practicesHelp develop innovative strategies to enhance care quality while reducing external review dependency Required Qualifications: Active, unrestricted MD or DO license in any U.S. stateHematology/Oncology background (Board Certification strongly preferred)5+ years of clinical oncology experienceStrong expertise in oncology case review, including chemotherapy, dosing, site-of-care, and treatment determinationsExcellent written communication and peer-to-peer discussion skillsAbility to thrive in a dynamic, evolving, and less structured environment Preferred Qualifications: Prior Utilization Management experienceExperience with InterQual, MCG, or clinical policy guidelinesPrevious health plan, payer-side, or physician advisor experienceMedical Director leadership experienceBackground in building internal clinical programs or reducing external review spend Schedule & Work Environment: Full-time, 40+ hours/weekMonday Friday standard schedulePrimarily remote after onboardingEast Coast or Central hours preferredWeekly rounds participation expectedLight travel: initial onboarding onsite + annual Ohio meeting Compensation & Benefits Highlights: Approximate Base Salary: $275K25% Performance BonusPotential Sign-On Bonus FlexibilityRemote Flexibility with minimal travelStrategic leadership visibility with senior clinical executivesOpportunity to shape oncology strategy, virtual care innovation, and cost-of-care initiatives Why This Role: This is more than a traditional utilization review position it s an opportunity to directly shape oncology care delivery, influence policy, and help build a modernized internal oncology management program with significant executive exposure. Ideal for a Hem/Onc physician seeking strategic leadership beyond direct patient care.