Medical Director
Teamware Solutions
- Job
- 29758
- Posted
- Location
- Remote
- Work type
- Contract
- Tax terms
- W2, C2C, 1099
- Experience
- Experience open
- Openings
- 1 opening
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Skills
- Public Health
- Director
- Utilization Management
About the job
Required Qualifications
- MD or DO degree.
- Minimum of 5 years of direct patient care experience.
- Board certification through an ABMS- or AOA-recognized specialty board.
- Active medical license in Pennsylvania, New York, or West Virginia.
- Strong utilization management (UM) experience on the health insurance/payer side is highly preferred. Hospital-based UM experience alone is not sufficient.
- Knowledge of managed care, case management, and clinical decision-making.
- Strong analytical, communication, and collaboration skills.
Preferred Qualifications
- Master's degree in Business Administration (MBA), Management, or Public Health (MPH).
- At least 1 year of medical management experience with a health insurance plan.
- Experience using MCG or InterQual criteria.
Additional Requirements
- Must successfully complete the Medical Director Assessment.
- Expected to review 55+ cases per 8-hour workday.
- Experience with Predictal and Beacon review systems is relevant.
- Candidates must be categorized as either Behavioral Health or Non-Behavioral Health (Physical Health) during submission.