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Senior Medical Director: Utilization Review & Policy Lead
Job in
New York, New York County, New York, 10261, USA
Listed on 2026-08-30
Listing for:
Brighton Health Plan Solutions, LLC
Full Time
position Listed on 2026-08-30
Job specializations:
-
Healthcare
Healthcare Management
Job Description & How to Apply Below
Brighton Health Plan Solutions, LLC is seeking a Medical Director to perform utilization review and medical necessity determinations for self-funded commercial plans. The role supports the CMO, focusing on clinical decision-defensibility and policy alignment across reviews and appeals.
You will lead peer discussions, mentor nurse reviewers, and participate in accreditation activities while maintaining clinical currency through CME and licensure upkeep. NY licensure is required.
#J-18808-LjbffrPosition Requirements
10+ Years
work experience
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