Remote Medical Director: Utilization & Clinical Leadership

The Judge Group; United States; On-site; USD 180,000 - 260,000; Full time

Job summary

The Judge Group is seeking an experienced Physical Health Medical Director to provide clinical leadership, medical oversight, and utilization management within our Physical Health Medical Management team. This physician leader will support evidence-based decision making across physical health services while driving clinical excellence and regulatory compliance.

This is a primarily remote role, with preference for North Carolina residents or those willing to relocate.

Qualifications

• MD or DO from an accredited medical school.
• Minimum 4 years of post-graduate clinical practice.
• Minimum 2 years in managed care, utilization management, or medical review.
• Active North Carolina medical license or eligibility.
• Board certification in Family Medicine or Internal Medicine, or related specialty.

Responsibilities

• Review requests for physical health services and determine authorization decisions.
• Apply medical necessity criteria to ensure appropriate utilization.
• Conduct initial and concurrent reviews, appeals, and utilization management.
• Ensure regulatory compliance and alignment with organizational policies.
• Provide leadership to multidisciplinary teams and drive process improvements.
• Participate in external mediation and provide clinical testimony as needed.

Skills

Clinical leadership

Utilization management

Evidence-based medicine

Regulatory compliance

Communication with leadership

Education

MD/DO

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 within our Physical Health Medical Management team. This physician leader will support evidence-based decision making across physical health services while driving clinical excellence and regulatory compliance.

This is a primarily remote role, with preference for North Carolina residents or those willing to relocate.