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Karrie Ruch
Recruiter @ The Jacobson Group | Insurance Talent Acquisition
Job Description:
A health plan is looking for a Medical Director to support with utilization management reviews and approvals. More specifically, this professional will ensure medical decisions are rendered by qualified medical personnel and medical care meets quality standards. The Medical Director will also lead the prior authorization medical necessity review process and develop utilization management criteria and clinical protocols to ensure utilization management, case and disease management regulatory requirements and accreditation standards are met. This opportunity is anticipated to be 6+ months in duration and is work-from-home.
Requirements:
Active and unrestricted Doctor of Medicine license in the state of California
2+ years of experience working in managed care, physician group management or integrated healthcare system management
2+ years of experience working with utilization management care reviews and approvals
5+ years of experience practicing medicine
Seniority level
Director
Employment type
Contract
Job function
Health Care Provider
Industries
Health and Human Services and Insurance
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