State Licensed Medical Director - job 9 of 38

Job Summary

A company is looking for a Medical Director - Medicaid Northeast.

Key Responsibilities

• Oversee Utilization Management, including prior authorization and concurrent review for Medicaid plans
• Ensure timely responses to members and providers regarding precertification, concurrent review, and appeal requests
• Participate in a rotating on-call schedule for weekend and holiday coverage

Required Qualifications

• Five or more years of experience providing direct patient care
• Active state medical license without encumbrances, with willingness to obtain licensure in other states as needed
• M.D. or D.O. with current and active board certification in an ABMS or AOA recognized specialty
• Preferred board certification in Physical Medicine & Rehabilitation, Emergency Medicine, Family Medicine (with hospitalist experience), or Internal Medicine
• Experience in physician leadership is preferred