Remote Medical Director: Policy, Utilization & QA

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

Benefits offered by this job

Comprehensive medical, dental, and VIs

Paid time off

Retirement savings options

Wellness programs

Well-being resources

Job summary

Ladders seeks a Medical Director (Remote - US) to lead medical policy implementation and guide clinical decision-making across the Midland States region. The role collaborates with Medical Management, providers, and facilities to ensure timely responses to members and robust care delivery.

Strong UM and physician advisor background is preferred. Candidate must have an MD/DO with board certification and an active license, plus post-graduate clinical care experience.

Qualifications

• 5+ years of experience in a health care delivery system, including clinical practice and the health care industry.
• Active medical license without encumbrances in the specified states.
• M.D. or D.O. with board certification in an ABMS- or AOA-recognized specialty
• Post-graduate direct patient care experience
• Preferred: previous UM experience with a health plan, payor, or physician advisor background

Responsibilities

• Oversee medical policy implementation
• Develop, implement, and evaluate clinical and medical programs
• Support Medical Management staff in providing timely responses to members and providers
• Focus on utilization review and quality assurance
• Conduct predetermination reviews and claim determinations
• Provide clinical, coding, and reimbursement expertise
• Serve as the lead liaison to network providers and facilities

Skills

Utilization review

Quality assurance

Physician advisor

Clinical practice

Education

MD/DO with ABMS- or AOA-certified specialty

Job description

Ladders seeks a Medical Director (Remote - US) to lead medical policy implementation and guide clinical decision-making across the Midland States region. The role collaborates with Medical Management, providers, and facilities to ensure timely responses to members and robust care delivery.

Strong UM and physician advisor background is preferred. Candidate must have an MD/DO with board certification and an active license, plus post-graduate clinical care experience.