Illinois Licensed Medical Director
A company is looking for a Medical Director - Medicaid (IL). Key Responsibilities Oversee Utilization Management, including prior authorization and concurrent review for inpatient and outpatient services Ensure timely responses to members and providers regarding precertification, concurrent review, and appeal requests Participate in a rotating on-call schedule for weekend and holiday coverage Required Qualifications Five or more years of experience providing direct patient care Illinois state medical license without encumbrances M.D. or D.O. with current and active board certification in an ABMS or AOA recognized specialty Board certification in Family Medicine or Internal Medicine/Pediatrics Prior Utilization Management experience at a health plan or as a Physician Advisor is a plus
A company is looking for a Medical Director - Medicaid (IL).
Key Responsibilities
Oversee Utilization Management, including prior authorization and concurrent review for inpatient and outpatient services
Ensure timely responses to members and providers regarding precertification, concurrent review, and appeal requests
Participate in a rotating on-call schedule for weekend and holiday coverage
Required Qualifications
Five or more years of experience providing direct patient care
Illinois state medical license without encumbrances
M.D. or D.O. with current and active board certification in an ABMS or AOA recognized specialty
Board certification in Family Medicine or Internal Medicine/Pediatrics
Prior Utilization Management experience at a health plan or as a Physician Advisor is a plus
