Remote Medical Director, Utilization Management

Bickham Services Unlimited, LLC; Henderson (NV); Remote; USD 180,000 - 240,000; Full time

Benefits offered by this job

Remote work

Competitive contract terms

Immediate start

Job summary

Bickham Services Unlimited, LLC seeks a Medical Director, Utilization Management for a 6-9 month contract based in Henderson, NV, with remote work option. Immediate start favored for reviewing inpatient and post-acute care decisions for Commercial and Medicare Advantage populations.

Must have MD/DO and board certification, with 5+ years in clinical practice including 3+ years in UM or medical leadership within managed care.

Qualifications

• Utilization reviews for inpatient admissions, continued stays, and post-acute care.
• Apply CMS, MCG, InterQual guidelines to determine medical necessity.
• Interpret and apply commercial and Medicare Advantage coverage policies.
• Collaborate with care teams to ensure compliant and cost-effective care.
• Document all determinations in line with CMS/NCQA requirements.

Responsibilities

• Lead utilization management activities across inpatient and post-acute settings.
• Act as physician reviewer for escalated or complex cases requiring clinical judgment.
• Partner with UM and care management teams to optimize patient outcomes and cost efficiency.
• Engage in peer-to-peer discussions to clarify documentation and care levels.
• Support policy development, audits, and regulatory compliance.

Skills

Utilization management

Clinical leadership

CMS guidelines

InterQual

Medical review

Data analysis

Education

MD/DO

Board-certified

Tools

Med management systems

MS Office

Job description

Bickham Services Unlimited, LLC seeks a Medical Director, Utilization Management for a 6-9 month contract based in Henderson, NV, with remote work option. Immediate start favored for reviewing inpatient and post-acute care decisions for Commercial and Medicare Advantage populations.

Must have MD/DO and board certification, with 5+ years in clinical practice including 3+ years in UM or medical leadership within managed care.