Remote National Medical Director
Core
Provide medical leadership for utilization management, cost containment, and quality improvement activities for a business unit, ensuring timely decision-making on complex medical services.
Role type
Senior National Medical Director (Utilization Management)
Builds
Utilization management programs, quality improvement initiatives, and provider network strategies
Domain
Healthcare administration and insurance
Required skills
Medical leadership, utilization management, quality improvement, claims review, provider network development, regulatory compliance, performance improvement planning
Preferred skills
Health administration knowledge, cultural diversity management, committee management, physician education
Technologies
None stated
Responsibilities
Direct medical management and credentialing functions, perform medical reviews for utilization and quality assurance, conduct rounds for high-risk patients, collaborate on complex case appeals, develop provider alliances, represent the business unit at state committees, evaluate adverse utilization trends
Seniority
Senior, strategic leadership with hands-on clinical oversight