Job Description:
A health plan company is seeking a Medical Director to support utilization management reviews and approvals. The Medical Director will ensure medical decisions are rendered by qualified medical personnel and medical care meets quality standards. This opportunity is anticipated to last6+ monthsand is remote.
Responsibilities:
- Lead the prior authorization medical necessity review process.
- Develop utilization management criteria and clinical protocols.
- Ensure compliance with utilization management, case and disease management regulatory requirements, and accreditation standards.
Requirements:
- Active andunrestricted Doctor of Medicine licensein the state of California
- 2+ years of experience working in managed care, physician group managementor integrated healthcare system management
- 2+ years of experience working with utilization management care reviews and approvals
- 5+ years of experience practicing medicine
Contact:
Karrie Ruch
+1 (312) 884-0418
kruch@jacobsononline.com
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