Medical Director
Remote · Louisville, Kentucky, United States or New York City, New York, United States
Louisville, Kentucky, United States or New York City, New York, United StatesRemoteFull TimeSenior LevelLicense Or CertificationUnknown
Type
Full Time
Level
Senior Level
Education
License Or Certification
Company size
Unknown
Job Summary
The Medical Director is responsible for evaluating clinical information and conducting thorough reviews of medical necessity for healthcare services, ensuring compliance with clinical guidelines. This fully remote role offers a non-clinical workload with predictable weekends and focuses on maintaining high productivity and quality metrics.
Required Qualifications
- MD or DO degree
- Minimum of 5 years of direct patient care experience after residency or fellowship, ideally with inpatient exposure or experience treating adult/older adult populations
- Current board certification in an ABMS-recognized specialty
- Active, unrestricted medical license in at least one U.S. jurisdiction, and willingness to obtain additional licensure if needed
- No active sanctions and able to meet credentialing requirements
- Strong written and verbal communication skills
- Demonstrated analytical skills and experience working effectively within multidisciplinary teams
Desired Qualifications
- Prior experience in managed care, clinical review, utilization management, or health plan operations
- Familiarity with clinical review guidelines (e.g., InterQual, MCG)
- Experience in hospital-based specialties such as Internal Medicine, Family Medicine, Geriatrics, Hospitalist Medicine, Emergency Medicine, or related fields
- Ability to navigate fast-paced, highly regulated environments
- Comfort using technology to support workflow efficiency
- Commitment to continuous learning, adaptability, and process improvement
- Interest in contributing to training or educational initiatives within the organization
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