Medical Director (Remote โ USA)
100% Remote | Must have an active, unrestricted state medical license
About the Role
Seeking an experiencedย Medical Directorย to provide clinical oversight, support medical policy implementation, and ensure quality assurance across programs. This is a fully remote role supporting clinical teams, utilization review, and healthcare program operations.
Key Responsibilities
- Provideย clinical oversight and decision-makingย to support medical management programs.
- Overseeย utilization review, quality assurance, and case management support.
- Collaborate withย clinical staff, account teams, and healthcare providersย to improve care outcomes.
- Review and interpret regulatory and compliance requirements (HIPAA, credentialing, documentation standards).
- Participate in theย development and evaluation of clinical/medical programs.
Required Qualifications
M.D. or D.O., Board Certified in a recognized specialty with post-graduate direct patient care experience.
Active, unrestricted U.S. state medical license
2โ3 years of leadership experienceย as a Medical Director (or equivalent) in clinical oversight or healthcare operations.
Strongย regulatory/compliance expertiseย and ability to prepare/utilize medical documentation effectively.
Epic EMR experienceย and strong computer skills.
Private home office with reliable high-speed internet.
Preferred Qualifications
- Health plan/payor orย managed careย experience.
- Experience collaborating withย multidisciplinary clinical teams.
- Strong knowledge ofย appeals, authorizations, and denial management.