Medical Director (Utilization Management) –Hybrid/Remote Role!

Medical Director (Utilization Management) - Remote Role! Compensation: $225,000 to $275,000/year Schedule: Full-time (Remote) Job Summary The Utilization Management Medical Director is a key physician responsible for advancing clinical excellence, quality outcomes, utilization management, and provider engagement across the network. This role provides clinical oversight, supports evidence-based care delivery, and partners with providers, care management teams, and operational leaders to improve healthcare quality, patient outcomes, and effective stewardship of healthcare resources. The Medical Director helps ensure compliance with regulatory requirements, supports utilization and population health initiatives, and contributes to strategic growth through provider recruitment, retention, and network development. With a focus on aligning clinical, operational, and organizational priorities, this role serves as a trusted physician leader in advancing value-based care and high-performing provider networks. You Will Focus On Clinical Leadership Quality Improvement Provider Relations Utilization Management & Care Coordination Utilization Management Committee Leadership Compliance And Regulation Strategic Planning and Network Growth: Provider Recruitment and Retention Qualifications MD or DO degree from an accredited medical school Active and unrestricted medical license Minimum of 5 years of clinical experience, with at least 3 years in a leadership role Required Certification: Board certification in a medical specialty Strong understanding of quality improvement methodologies and healthcare regulations. Excellent communication, leadership, and interpersonal skills. Preferred Qualifications Experience in an IPA, health plan, ACO, delegated medical group, managed care, or value-based care environment. Experience with utilization management, medical necessity review, provider appeals, care management, population health, and quality improvement programs strongly preferred. Prior experience serving as a Medical Director, Associate Medical Director, or Physician Advisor supporting utilization management, care management, population health, or quality programs. Experience working with delegated managed care arrangements, health plan partners, and utilization management committees. Benefits Excellent medical, vision, and dental coverage 401k savings plan with a company match Flexible time off and 9 Paid Holidays