Remote Medical Director-Utilization Management 253754

Remote Medical Director - Utilization Management (6-12 month contract, potential for long-term hire!) Must hold MD license in PA, NY or WV.Job Summary Medix is partnering with a premier national health plan to identify an experienced Medical Director for a Utilization Management engagement. This role is designed for a physician with a strong background in payer-side medical management who can seamlessly integrate into a high-impact clinical review team. You will support the organization’s commitment to quality care and operational excellence by ensuring medical necessity and appropriateness of care for members.ResponsibilitiesConduct utilization management reviews for medical necessity and appropriateness of clinical care.Review escalated cases utilizing established medical policy criteria, ensuring clinical accuracy.Participate in peer-to-peer discussions with providers to facilitate collaborative clinical outcomes.Required QualificationsMedical Degree (MD or DO) from an accredited program.Current Board Certification in a recognized clinical specialty.Active, unrestricted medical license (Must hold a license in Pennsylvania, West Virginia, or New York).Extensive experience in payer-side/health insurance utilization management specifically as a Medical Director.Compensation and BenefitsCompetitive compensation ranging from $130.00 to $140.00 per hour, commensurate with experience.Fully remote work environment.Comprehensive equipment provided by the client.Stable 40-hour work week with a flexible schedule (typically 8:30 AM – 5:00 PM EST).