UM Medical Director DME - Pacific or Mountain Time Zone preferred - Remote

Remote, US-based candidates only; no visa sponsorship available.

About the role

This role 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. The position offers the opportunity to strengthen care quality, team performance, and measurable outcomes within a healthcare environment.

Responsibilities

• Conduct coverage reviews based on individual member plan benefits and coverage policies
• Document clinical review findings and outcomes per regulatory requirements
• Engage in peer-to-peer discussions with requesting providers
• Interpret benefit language and policies during coverage reviews
• Participate in daily clinical rounds as needed
• Communicate with network and non-network providers to ensure timely benefit determinations
• Collaborate with internal partners
• Participate in call coverage rotation

Qualifications

• M.D. or D.O.
• Active unrestricted license to practice medicine
• Board certification in relevant specialty (Physical Medicine & Rehabilitation, Internal Medicine, Emergency or Family Medicine)
• 3+ years of clinical practice experience post-residency
• Understanding of Evidence Based Medicine (EBM)
• Proficient in PC applications, particularly MS Word, Outlook, and Excel

Pay

$248,500 – $373,000 annually

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution options
• Flexible remote work policy (with some geographic office requirements)
• Career development opportunities