UM Medical Director - Pediatrics and Internal Medicine - Remote

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.

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

Responsibilities

• Conduct individual coverage reviews based on member plan benefits
• Document clinical review findings per policies and regulations
• Engage in peer-to-peer discussions with requesting providers
• Interpret benefit language during clinical coverage reviews
• Participate in daily clinical rounds as requested
• Collaborate with providers for accurate benefit determinations
• Communicate with internal partners to uphold review processes

Qualifications

• M.D or D.O. required
• Board certified in Internal Medicine and Pediatrics
• Active unrestricted medical license
• 5+ years of clinical practice experience post-residency
• Strong understanding of Evidence Based Medicine (EBM)
• Proficient with MS Word, Outlook, and Excel
• Willingness to participate in holiday and call coverage

Pay

$248,500 – $373,000 annually

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase option
• 401k contribution opportunity
• Remote work flexibility within the U.S.