Remote Medical Director – Clinical Policy & Utilization

Valenz; Phoenix (AZ); On-site; USD 90,000 - 130,000; Part time

Benefits offered by this job

Medical, Dental, Vision

401(k) with match

Paid Time Off

Remote work environment

HSA/FSA options

Employee discounts

Job summary

Valenz is seeking a Part-Time Medical Director to lead medical management and utilization review programs. You will ensure decisions and policies align with evidence-based medicine, regulatory requirements, and organizational standards.

You will support quality initiatives, complex determinations, and clinical program development, serving as a trusted advisor to leadership and cross-functional teams.

Qualifications

• MD or DO degree with an active, unrestricted medical license.
• Board certification in a recognized specialty.
• Experience with utilization management, medical policy development, and clinical program oversight.
• Familiarity with CMS, URAC, and state-specific requirements.
• Strong interpersonal, organizational, and analytical skills.

Responsibilities

• Provide physician leadership in evidence-based guidelines and utilization management policies.
• Ensure programs align with standards, accreditation, and regulations.
• Act as clinical authority for complex utilization review cases.
• Collaborate to develop and revise clinical and administrative policies.
• Monitor guidelines, regulations, and payer requirements; recommend updates.
• Review outcomes and participate in Quality Committee meetings.

Skills

MD/DO license

Board certification

Utilization management

Medical policy development

Regulatory knowledge

Communication skills

Education

MD/DO degree

Job description

Valenz is seeking a Part-Time Medical Director to lead medical management and utilization review programs. You will ensure decisions and policies align with evidence-based medicine, regulatory requirements, and organizational standards.

You will support quality initiatives, complex determinations, and clinical program development, serving as a trusted advisor to leadership and cross-functional teams.