Florida Licensed Medical Director

A company is looking for a Medical Director Care Management. Key Responsibilities: Perform all types of utilization management (UM) reviews, including Pre-service, Post-service, Concurrent Review, and Appeals Discuss cases with physician providers (Peer to Peer) and collaborate with Case Managers for support and guidance Meet established metrics related to UM review efficiency, participate in audits, and assist staff in understanding clinical concepts Required Qualifications: Current unrestricted Florida medical license as a Doctor of Medicine or Doctor of Osteopathic Medicine Board Certification or Board eligibility by American Board of Medical Specialties or equivalent Utilization management experience 5+ years of clinical experience Experience working both independently and in a team environment

May 23, 2025 - 16:40

A company is looking for a Medical Director Care Management. Key Responsibilities: Perform all types of utilization management (UM) reviews, including Pre-service, Post-service, Concurrent Review, and Appeals Discuss cases with physician providers (Peer to Peer) and collaborate with Case Managers for support and guidance Meet established metrics related to UM review efficiency, participate in audits, and assist staff in understanding clinical concepts Required Qualifications: Current unrestricted Florida medical license as a Doctor of Medicine or Doctor of Osteopathic Medicine Board Certification or Board eligibility by American Board of Medical Specialties or equivalent Utilization management experience 5+ years of clinical experience Experience working both independently and in a team environment