Job Description
New York Metro Area (Candidates Must Reside in NY, NJ, or CT)
Full-Time Hybrid Leadership Opportunity
Total Compensation Range: $200k - $225k
We are seeking an experienced Medical Director of Utilization Management to provide clinical leadership within a growing health plan environment serving Medicare and Medicaid populations.
This is an outstanding opportunity for a physician who enjoys collaborating across multidisciplinary teams, driving quality outcomes, ensuring regulatory compliance, and helping members receive the right care at the right time.
What You'll Do
- Serve as the physician leader and clinical resource for Utilization Management operations.
- Conduct medical necessity reviews, peer-to-peer consultations, and appeal determinations.
- Partner with executive leadership to develop and execute medical management initiatives.
- Moni...