Pennsylvania Licensed Medical Director

A company is looking for a Medical Director to provide physician leadership supporting medical decision-making across health plan operations.

Key Responsibilities of the Medical Director :

Provide physician leadership for utilization and care management activities

Apply evidence-based clinical guidelines to evaluate medical necessity and quality

Collaborate with clinical teams and external partners to promote patient-centered care

Qualifications and Skills for the Medical Director :

Medical Doctor (MD) or Doctor of Osteopathy (DO) from an accredited institution

Active, unrestricted Pennsylvania medical license

Current board certification through ABMS or AOBMS; family or internal medicine preferred

Strong clinical judgment in utilization management and health insurance frameworks

Ability to complete required credentialing processes