Remote Medical Director, Utilization & Quality Leadership

Magellan Health, Inc.; United States; Remote; USD 200,000 - 361,000; Full time

Benefits offered by this job

Comprehensive benefits package

Short-term incentives

Equal Opportunity Employer

Job summary

Magellan Health is seeking a Medical Director (BH, UM) for a remote position servicing Hawaii. The role requires Hawaii licensure and supports clinical leadership across Medicaid, Medicare, and Commercial lines.

It involves physician oversight of an interdisciplinary team, utilization management, quality improvement, and collaboration with corporate clinical teams. The position offers full-time or part-time options with a competitive base salary and comprehensive benefits, plus potential

Qualifications

• MD/DO/MBBS or international equivalent required
• Unrestricted current and valid medical license in a US state or territory
• Post-residency clinical experience with direct patient care
• Experience with cost-benefit analysis, credentialing, quality assurance and CQI processes
• Must be able to provide after-hours coverage

Responsibilities

• Provides clinical leadership to the interdisciplinary Medical Management team and physician oversight of care managers
• Develops and implements Utilization Management programs and ensures appropriate, cost-effective care
• Contributes to NCQA/URAC certifications and quality improvement activities
• Maintains licensure requirements across states as assigned and participates in committees
• Supports design and execution of medical action plans and parity analyses
• Assists in committee work and contributes to provider relations and client-specific requirements

Education

MD/DO/MBBS

Job description

Magellan Health is seeking a Medical Director (BH, UM) for a remote position servicing Hawaii. The role requires Hawaii licensure and supports clinical leadership across Medicaid, Medicare, and Commercial lines.

It involves physician oversight of an interdisciplinary team, utilization management, quality improvement, and collaboration with corporate clinical teams. The position offers full-time or part-time options with a competitive base salary and comprehensive benefits, plus potential