Remote Medical Director, Psychiatry & Utilization Management

Curative HR LLC; Austin (TX); Remoto; USD 250.000 - 320.000; Tempo integral

Benefícios oferecidos por esta vaga

100% employer-covered medical premiums

Dependent coverage 50%

Zero copays and deductibles

Generous PTO and 11 holidays

401K

Paid parental leave 8–12 weeks

Flexible spending accounts

Remote and in-person options

Maternity and family planning support

Resumo da vaga

Curative is seeking an enthusiastic and highly skilled Medical Director to join our growing team. To qualify for this position, you must be board certified in Psychiatry.

This pivotal role will oversee utilization reviews, prior authorizations, and make medical necessity determinations in a fast-paced startup environment. This remote leadership position requires strong communication with practitioners, collaboration with care teams, and a focus on evidence-based care while balancing cost

Qualificações

• Minimum 5 years of clinical practice experience.
• 2–3 years in utilization management or prior authorizations.
• Strong communication and peer-to-peer dialogue skills.
• Understanding of medical necessity criteria and evidence-based care.

Responsabilidades

• Perform comprehensive medical necessity reviews (prospective, concurrent, retrospective).
• Lead prior authorization reviews aligned with clinical criteria and regulations.
• Conduct peer-to-peer discussions with external practitioners and provide clear rationales.
• Issue denials with well-documented rationales in line with regulations and appeals.
• Collaborate with Nurse Practitioners, Care Coordinators, and Operations to optimize utilization.
• Develop, review, and revise medical policies and utilization protocols.
• Participate in quality improvement initiatives and committee work.
• Maintain meticulous documentation of reviews and interactions.
• Stay current with medical literature and industry best practices.
• Balance clinical efficacy with cost-effectiveness and member-centric care.

Conhecimentos

Analytical thinking

Communication skills

Interpersonal skills

Remote work discipline

Leadership capability

Formação

MD or DO degree

Board Certification in Psychiatry

Ferramentas

EHR systems

Utilization management software

Descrição da vaga

Curative is seeking an enthusiastic and highly skilled Medical Director to join our growing team. To qualify for this position, you must be board certified in Psychiatry.

This pivotal role will oversee utilization reviews, prior authorizations, and make medical necessity determinations in a fast-paced startup environment. This remote leadership position requires strong communication with practitioners, collaboration with care teams, and a focus on evidence-based care while balancing cost