What are the responsibilities and job description for the Medical Director Physician position at Northeast Healthcare Recruitment?
We are seeking a remote Medical Director for Utilization Management . Based in Cerritos, CA, the Medical Director will oversee the administration of physical and / or behavioral health medical services, ensuring that patients receive a ppropriate and cost-effective medical care. This role includes developing and implementing programs to improve quality, cost, and clinical outcomes, providing strategic consultation, and i dentifying opportunities for innovation.
The Medical Director may also lead clinical programs, offer clinical guidance, and serve as a consultant and resource to both internal teams and external partners. A California license is not required and can be remote from anywhere in the US.
Compensation & Benefits : $263,488 - $395,232 plus excellent benefits package
Primary Responsibilities :
- Support clinicians to ensure timely and consistent responses to members and providers.
- Chart Review, Provide guidance on clinical operational aspects of programs.
- Conduct peer-to-peer clinical reviews with attending physicians or other providers regarding review determinations and patient visits.
- Represent the organization to external entities and serve on internal or external committees.
- Interpret and propose updates to medical policies and clinical guidelines based on healthcare changes.
- Lead, develop, and implement clinical and non-clinical initiatives that impact healthcare quality, cost, and outcomes.
- Identify and develop innovative opportunities to enhance effectiveness and quality.
- Full Time, Call 1 : 4
- 100% Virtual
- Apply Criteria, Utilization review
Requirements :
Additional Requirements :
This position offers a competitive compensation range, opportunities for professional growth, and the chance to lead impactful healthcare initiatives.
