Remote Medical Director: Utilization & Quality Leadership

Magellan Health, Inc.; Honolulu (HI); À distance; USD 200 000 - 361 000; Plein temps

Résumé du poste

Magellan Health is seeking a Medical Director (BH, UM) for a remote role requiring Hawaii licensure. The position supports clinical leadership for Medicaid, Medicare, and Commercial plans with physician oversight across the utilization management continuum.

Responsibilities include leading the Medical Management team, guiding case management, and developing clinical standards with Magellan’s Corporate Clinical team.

Qualifications

• MD/DO/MBBS with US-based internship and residency (preferred subspecialty).
• Active medical license in a US state or territory.

Responsabilités

• Provide clinical leadership to the interdisciplinary Medical Management team.
• Oversee case management and medical necessity decisions across care continuum.
• Develop and implement Utilization Management programs and action plans.
• Ensure compliance with NCQA, URAC, and other standards.
• Collaborate with practitioners, provider facilities, and client organizations.

Connaissances

Clinical leadership

Physician oversight

Utilization management

Quality improvement

Communication

Formation

MD/DO/MBBS

Description du poste

Magellan Health is seeking a Medical Director (BH, UM) for a remote role requiring Hawaii licensure. The position supports clinical leadership for Medicaid, Medicare, and Commercial plans with physician oversight across the utilization management continuum.

Responsibilities include leading the Medical Management team, guiding case management, and developing clinical standards with Magellan’s Corporate Clinical team.