Pennsylvania Licensed Medical Director

A company is looking for a Medical Director of Utilization Management.

Key Responsibilities

Implement evidence-based practice guidelines and oversee clinical care quality

Ensure compliance with medical policies, contracts, and regulatory requirements

Collaborate with teams to enhance clinical effectiveness and manage day-to-day operations

Required Qualifications, Training, and Education

MHA, MPH, or MBA in healthcare management preferred

Minimum of three years of utilization management or appeal experience preferred

Minimum of five years of clinical practice experience required

Doctor of Medicine (MD) or Doctor of Osteopathic Medicine with necessary state licensure

Board-certified in Family Medicine, Internal Medicine, Pediatrics, or Emergency Medicine