Medical Director

Title: Medical Director

Location: Remote

Duration: 6 Months with possible extension/Conversion FTE

We’re hiring a board-certified physician to support the Medicare Inpatient Pod. This role partners with the Chief Medical Director to lead utilization management, quality improvement, credentialing, and appeals for high-volume inpatient and post-acute care reviews. You’ll drive medical necessity decisions using Inter Qual/MCG, support discharge planning, mentor provider relationships, and help reduce readmissions while meeting productivity and audit targets.

$110.00/hr - $130.00/hr

• Provide medical leadership for utilization management, cost-containment, and quality improvement.
• Perform concurrent inpatient and post-acute reviews, and review complex/controversial services and claims appeals.
• Support physician committee functions and implement performance improvement initiatives.
• Conduct rounds for high-risk members and collaborate with care management.
• Develop physician education and provider relationships; represent the business unit as needed.
• Consult on SUD policy and MCM cases when required.

• Active board certification:
  Internal Medicine or Family Medicine.
• Active, unrestricted medical licenses in FL and TX.
• Hands-on experience with Inter Qual and/or MCG.
• Inpatient clinical background or prior physician advisor experience.

• Multi-state licenses (MI, MS, NJ, NC, CA, KS, AR).

• Productivity target: ~45+ cases/day.

• Job function:
  Management and Health Care Provider
• Industries:
  Hospitals and Health Care and Insurance