Medical Director - Prior Authorization - CA licensure required - Remote

About the role

This remote Medical Director position supports clinical priorities focused on quality, patient-centered outcomes, and effective care delivery. You will collaborate with clinical leaders, operational teams, and cross-functional stakeholders to improve standards, workflows, and execution, strengthening care quality, team performance, and measurable outcomes within a healthcare environment.

Responsibilities

• Work to improve quality and promote evidence-based medicine
• Manage prior authorization, utilization management, and claims review cases
• Provide quality and efficiency information to inform care choices
• Support initiatives enhancing quality within the national network
• Ensure timely service provision for each member
• Collaborate with medical director teams on inpatient and clinical reviews
• Demonstrate leadership and make autonomous decisions in a tech-driven role

Requirements

• MD or DO degree required
• Active, unrestricted physician state license in CA
• Current board certification through ABMS or AOA
• 5+ years of clinical practice experience post-residency
• Strong understanding of evidence-based medicine and managed care principles

Location: Remote – US-based candidates only, no visa sponsorship available

Pay

$248,500 – $373,000 annually

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase options
• 401k contribution
• Flexible remote work option within the U.S.