Remote Medical Director, Physical Health & Utilization

The Judge Group; North Carolina; On-site; USD 180,000 - 240,000; Full time

Job summary

The Judge Group is seeking an experienced Physical Health Medical Director to provide clinical leadership, medical oversight, and utilization management expertise within our Physical Health Medical Management team.

This physician leader will support high-quality, evidence-based decision making across physical health services while driving clinical excellence, regulatory compliance, and operational efficiency.

Qualifications

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited medical school.
• Minimum of 4 years of post-graduate clinical practice experience.
• Minimum of 2 years of managed care, utilization management, or medical review experience.
• Current, active, unrestricted North Carolina medical license, or eligibility to obtain North Carolina licensure.
• Board Certification in an applicable specialty (Family Medicine ABFM, Internal Medicine ABIM, or related).

Responsibilities

• Review requests for physical health services and make authorization decisions.
• Apply evidence-based medical necessity criteria.
• Conduct reviews for inpatient and outpatient services.
• Ensure regulatory compliance and operational efficiency.
• Provide clinical consultation to multidisciplinary teams.
• Mentor Medical Management staff.

Skills

Clinical leadership

Utilization management

Medical reviews

Communication with physicians

Analytical skills

Education

MD/DO degree

Tools

Microsoft Office Suite

Job description

The Judge Group is seeking an experienced Physical Health Medical Director to provide clinical leadership, medical oversight, and utilization management expertise within our Physical Health Medical Management team.

This physician leader will support high-quality, evidence-based decision making across physical health services while driving clinical excellence, regulatory compliance, and operational efficiency.