Remote Medical Director: Utilization & Quality Leadership

Magellan Health, Inc.; Honolulu (HI); Hybrid; USD 200,000 - 361,000; Full time

Benefits offered by this job

Comprehensive benefits package

Short-term incentives

Job summary

Magellan Health, Inc. seeks a Medical Director (BH, UM) for a remote role based in Hawaii. You will provide clinical leadership to the interdisciplinary Medical Management team and oversee utilization management across Medicaid, Medicare, and Commercial plans.

This role may support multiple health plans and requires physician oversight across case management and various levels of care. Active Hawaii licensure is required; MD/DO/MBBS and US internship/residency completion are essential.

Qualifications

• MD/DO/MBBS with successful completion of US-based internship and residency.
• Unrestricted current and valid license to practice medicine in a US state or territory.
• 3+ years post-residency clinical experience with direct patient care.

Responsibilities

• Provide physician oversight to the interdisciplinary Medical Management team.
• Lead utilization management activities to ensure medically necessary care.
• Develop and implement a Utilization Management program and action plan.
• Participate in NCQA/URAC certifications and quality improvement initiatives.
• Prepare for and participate in committee work and training activities.

Skills

Leadership

Cost-benefit analysis

Quality improvement

Education

DO/MBBS/MD degree

Job description

Magellan Health, Inc. seeks a Medical Director (BH, UM) for a remote role based in Hawaii. You will provide clinical leadership to the interdisciplinary Medical Management team and oversee utilization management across Medicaid, Medicare, and Commercial plans.

This role may support multiple health plans and requires physician oversight across case management and various levels of care. Active Hawaii licensure is required; MD/DO/MBBS and US internship/residency completion are essential.