Medical Director & Utilization Leader (Hybrid)

Medical Mutual; Brooklyn (OH); Hybrid; USD 250,000 - 300,000; Full time

Benefits offered by this job

Flexible remote work

Company match 401(k)

Tuition reimbursement up to $5,250

Access to fitness centers

Job summary

Medical Mutual is seeking a physician for a leadership role in utilization management based in Brooklyn, Ohio. The position involves overseeing physician review processes and ensuring compliance with clinical goals while fostering continuous improvement.

The ideal candidate will have an MD or DO, at least 5 years of clinical practice experience, and a background in the insurance industry. This hybrid role requires presence at the office on designated days.

Qualifications

• Must have an active, unrestricted license to practice medicine in the USA.
• Minimum of 5 years of clinical practice experience required.
• Experience as a physician reviewer preferred.

Responsibilities

• Oversee utilization review process and determinations.
• Participate in quality improvement projects.
• Ensure physician compliance with clinical goals.
• Recommend enhancements to managed care guidelines.

Skills

Leadership skills

Utilization management review

Clinical care practice experience

Understanding of managed care principles

Computer proficiency

Education

MD or DO from an accredited medical school

Board Certification in recognized specialty

Tools

Microsoft Office

Job description

Medical Mutual is seeking a physician for a leadership role in utilization management based in Brooklyn, Ohio. The position involves overseeing physician review processes and ensuring compliance with clinical goals while fostering continuous improvement.

The ideal candidate will have an MD or DO, at least 5 years of clinical practice experience, and a background in the insurance industry. This hybrid role requires presence at the office on designated days.