State Licensed Senior Medical Director

A company is looking for a Senior Medical Director to lead and manage a team of medical directors overseeing the appropriateness and medical necessity of services provided to members.

Key Responsibilities

Lead a team of medical directors in assessing health care service appropriateness and necessity

Provide leadership in prior authorization, inpatient concurrent review, and care management activities

Recruit, train, and develop medical director staff while ensuring compliance with regulatory standards

Required Qualifications

At least 8 years of relevant experience, including 2 years as a medical director in a managed care setting

At least 3 years of management or leadership experience

Doctor of Medicine (MD) or Doctor of Osteopathy (DO) with an active and unrestricted license

Board Certification and knowledge of applicable laws and regulations

Experience in strategic decision-making and collaboration within a matrixed organization