Medical Director (Remote – USA)
100% Remote | Must have an active, unrestricted state medical license
About the Role
Seeking an experienced Medical Director 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
- Provide clinical oversight and decision-making to support medical management programs.
- Oversee utilization review, quality assurance, and case management support.
- Collaborate with clinical staff, account teams, and healthcare providers to improve care outcomes.
- Review and interpret regulatory and compliance requirements (HIPAA, credentialing, documentation standards).
- Participate in the 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
2–3 years of leadership experience as a Medical Director (or equivalent) in clinical oversight or healthcare operations.
Strong regulatory/compliance expertise and ability to prepare/utilize medical documentation effectively.
Epic EMR experience and strong computer skills.
Private home office with reliable high-speed internet.
Preferred Qualifications
- Health plan/payor or managed care experience.
- Experience collaborating with multidisciplinary clinical teams.
- Strong knowledge of appeals, authorizations, and denial management.