Remote Medical Director: Lead Clinical Utilization

Ladders; United States; Remote; USD 174,000 - 375,000; Full time

Benefits offered by this job

Comprehensive medical/dental/vision

Paid time off

Retirement savings options

Wellness programs

Eligibility-based resources

Job summary

Ladders, a leader in healthcare, seeks a Medical Director - Keystone Market to guide clinical decision-making and medical management across a defined market. This remote leadership role focuses on utilization review, prior authorization support, and quality oversight while partnering with medical management staff, providers, and facilities.

Location: Remote - US based candidates only, no visa sponsorship available. Compensation: $174,070 – $374,920 annually.

Qualifications

• MD or DO with board certification in an ABMS- or AOA-recognized specialty.
• Post-graduate direct patient care experience.
• Active state medical license without encumbrances.
• Preferred: PA, WV, or DE medical license.

Responsibilities

• Oversee medical policy implementation and clinical program development.
• Evaluate and expand medical management programs to meet member needs.
• Support medical management staff with timely responses to inquiries.
• Conduct utilization review and quality assurance activities.
• Manage predetermination reviews, including prior authorization and concurrent reviews.
• Provide clinical expertise and direct case management as needed.
• Act as a liaison to network providers and facilities to support effective medical services execution.

Skills

Utilization management

Case management

Clinical leadership

Education

MD/DO with ABMS/AOA board

Job description

Ladders, a leader in healthcare, seeks a Medical Director - Keystone Market to guide clinical decision-making and medical management across a defined market. This remote leadership role focuses on utilization review, prior authorization support, and quality oversight while partnering with medical management staff, providers, and facilities.

Location: Remote - US based candidates only, no visa sponsorship available. Compensation: $174,070 – $374,920 annually.