Neonatal Utilization & Clinical Director

HireTalent; South Carolina; Remote; USD 250,000 - 350,000; Full time

Job summary

HireTalent seeks a Neonatologist Reviewing Medical Director to provide clinical leadership for NICU utilization management and neonatal operations in a virtual setting. You will review complex NICU cases, apply evidence-based criteria, and support Medicaid neonatal programs while collaborating with internal teams to ensure high-quality newborn care.

The ideal candidate is a board-certified Neonatologist with NICU utilization management experience and strong clinical expertise to make timely

Qualifications

• Board-certified Neonatologist with strong NICU utilization management experience.
• Evidence-based medical necessity determinations and Medicaid knowledge.
• Ability to perform timely, well-supported reviews and credentialing readiness.

Responsibilities

• Lead NICU clinical reviews and medical necessity determinations.
• Support Medicaid neonatal programs and neonatal clinical operations.
• Collaborate with providers, facilities, care management, and teams to improve outcomes.
• Provide cross-state utilization management guidance and policy adherence.
• Maintain knowledge of federal Medicaid regulations and neonatal policies.

Skills

Clinical leadership

Medical decision making

Regulatory compliance

Team collaboration

Medical documentation

Education

MD/DO degree

Neonatal-Perinatal Medicine board certification

Active medical license(s)

Tools

MHK

CGX

Job description

HireTalent seeks a Neonatologist Reviewing Medical Director to provide clinical leadership for NICU utilization management and neonatal operations in a virtual setting. You will review complex NICU cases, apply evidence-based criteria, and support Medicaid neonatal programs while collaborating with internal teams to ensure high-quality newborn care.

The ideal candidate is a board-certified Neonatologist with NICU utilization management experience and strong clinical expertise to make timely