Medical Director: Utilization & Care Management

Murtech Staffing & Solutions; United States; On-site; USD 180,000 - 240,000; Full time

Job summary

Murtech Staffing & Solutions seeks a Medical Director with active state licensure in PA, NY, or WV and utilization management experience. You will review escalated cases, participate in multidisciplinary care teams, and help develop clinical protocols to ensure compliance with NCQA, URAC, CMS, and related regulations.

The role requires MD or DO with board certification and at least five years of direct patient care.

Qualifications

• MD or DO degree with board certification from ABMS or AOA.
• Active medical state licensure in PA, NY, or WV.
• Minimum 5 years in clinical direct patient care.
• Strong critical thinking, case management, and customer service.

Responsibilities

• Conduct electronic review of escalated cases against medical policy criteria and determine medical necessity.
• Participate in CMDM multidisciplinary team, attend huddles and grand rounds.
• Assist in protocol and guidelines development to ensure consistency in review.
• Lead or participate in physician-led projects to improve care quality.
• Perform other duties as assigned.

Skills

MD/DO

Active state licensure (PA/NY/WV)

Clinical skills

Critical Thinking

Case Management

Customer Service

Telephone Skills

General Computer Skills

Clinical Software

Managed Care

Education

Board Certification (ABMS/AOA)

MD/DO degree

Job description

Murtech Staffing & Solutions seeks a Medical Director with active state licensure in PA, NY, or WV and utilization management experience. You will review escalated cases, participate in multidisciplinary care teams, and help develop clinical protocols to ensure compliance with NCQA, URAC, CMS, and related regulations.

The role requires MD or DO with board certification and at least five years of direct patient care.