Florida Licensed Medical Director

Job Summary

A company is looking for a Medical Director of Care Management specializing in Utilization Management (Remote).

Key Responsibilities:

• Perform various types of utilization management (UM) reviews, including Pre-service, Post-service, Concurrent Review, and Appeals
• Discuss cases with physician providers and collaborate with Case Managers for support on cases needing physician assistance
• Meet established metrics related to UM review efficiency, participate in audits, and assist staff in understanding utilization review principles

Required Qualifications:

• Current unrestricted Florida medical license as a Doctor of Medicine or Doctor of Osteopathic Medicine
• Board Certification or Board eligibility by the American Board of Medical Specialties or equivalent
• 5+ years of clinical experience
• Experience in a dynamic, fast-paced environment
• Experience working independently and in a team environment