Kentucky Licensed Medical Director - job 1 of 2

Job Summary

A company is looking for a Medical Director to support a critical system migration initiative remotely.

Key Responsibilities:

• Provide medical oversight of utilization management and clinical care reviews
• Evaluate authorization requests for medical necessity and regulatory compliance
• Participate in clinical appeals, quality reviews, and adverse incident investigations

Required Qualifications:

• MD or DO with active, unrestricted Kentucky medical license
• Minimum 3 years of clinical experience
• At least 2 years of experience as a Medical Director in clinical or managed care settings
• Strong knowledge of Medicaid, Medicare, and managed healthcare systems