Remote Medical Director, Utilization & Quality Oversight

Spectraforce; United States; Remote; USD 190,000 - 200,000; Full time

Job summary

A healthcare management company is seeking a fully remote Medical Director to support their team in utilization management and clinical oversight for high-volume cases. The ideal candidate will have an MD or DO with board certification in Internal Medicine or Family Practice, along with 4–7 years of clinical experience. Responsibilities include providing medical leadership, conducting case reviews, and collaborating on quality improvement initiatives. Salary ranges from $190,000 to $200,000, reflecting the role's seniority.

Qualifications

• 4–7 years of clinical experience with a strong foundation in patient care.
• Proven Utilization Management experience preferred.
• Familiarity with clinical policy development or quality improvement projects.

Responsibilities

• Provide medical leadership for utilization management and quality improvement.
• Conduct rounds for high-risk members and develop physician education.
• Review 40–50 medical cases per day using Centene’s EMR and UM systems.

Skills

Utilization Management (UM)

Clinical experience

InterQual

MCG

Education

MD or DO with active, unrestricted U.S. medical license

Board certification in Internal Medicine or Family Practice

Job description

A healthcare management company is seeking a fully remote Medical Director to support their team in utilization management and clinical oversight for high-volume cases. The ideal candidate will have an MD or DO with board certification in Internal Medicine or Family Practice, along with 4–7 years of clinical experience. Responsibilities include providing medical leadership, conducting case reviews, and collaborating on quality improvement initiatives. Salary ranges from $190,000 to $200,000, reflecting the role's seniority.