Medical Director

Job description

Medical Director
Location: New York, USA – REMOTE
Offering Competitive Compensation

As the Medical Director, you will be instrumental in assessing clinical data, analyzing medical records, and rendering expert judgments on requested healthcare services. Your responsibilities will encompass comprehensive clinical evaluations, integrating complex inpatient and outpatient cases, and engaging with external providers to obtain necessary information. This position demands strong clinical acumen, professionalism, and an adeptness for teamwork in a collaborative environment. The benefits include consistent weekends off, a non-clinical workload, contract-to-hire security, absence of patient grievances or productivity concerns, and a well-defined structure with decision-making guidelines.

Key Responsibilities of the Medical Director:

• Conduct prompt and compliant medical necessity evaluations for inpatient or related clinical services.
• Implement national clinical guidelines, regulatory standards, internal protocols, and clinical criteria to assess the suitability of services.
• Effectively communicate decisions clearly and professionally, both in writing and verbally.
• Engage in clinical dialogues with external providers to clarify information and justify decisions.
• Achieve and sustain strong performance in productivity, quality, and compliance metrics.
• Work independently post-onboarding while consulting with team members as needed.
• Adapt to changing workflows, tools, and utilization management practices.
• Promote a culture centered on collaboration, consistency, and high-quality clinical decision-making.

Requirements for the Medical Director:

• Possess an MD or DO degree.
• Have a minimum of 5 years of direct patient care experience following residency or fellowship, preferably with exposure to inpatient care or experience treating adult/older adult populations.
• Current board certification in a recognized specialty by the ABMS.
• Hold an active, unrestricted medical license in at least one U.S. jurisdiction, with a willingness to obtain additional licenses as necessary.
• No existing sanctions and must meet credentialing standards.
• Excellent written and oral communication abilities.
• Proven analytical skills and experience collaborating effectively in multidisciplinary teams.

Preferred Qualifications for the Medical Director:

• Experience in managed care, clinical review, utilization management, or health plan operations.
• Familiar with clinical review guidelines such as InterQual or MCG.
• Background in hospital-based specialties like Internal Medicine, Family Medicine, Geriatrics, Hospitalist Medicine, Emergency Medicine, or analogous areas.
• Aptitude for navigating fast-paced, highly regulated environments.
• Proficiency with technology to enhance workflow efficiency.
• Commitment to continuous learning, flexibility, and process improvement.
• Interest in participating in training or educational programs within the organization.

???????