Remote Medical Director

The Medical Director plays a key role in evaluating clinical information, interpreting medical records, and providing expert decisions regarding requested healthcare services. This includes conducting thorough clinical reviews, synthesizing complex inpatient and outpatient scenarios, and engaging directly with external providers to gather additional information when needed. This role requires strong clinical judgment, professionalism, and the ability to collaborate effectively within a team-oriented environment.

This role includes benefits such as predictable weekends, non-clinical workload, contract-to-hire stability, no patient complaints or RVU’s, and clear structure and decision guidelines.

• Perform timely, compliant medical necessity reviews for inpatient or related clinical services
• Apply national clinical guidelines, regulatory requirements, internal policies, and clinical standards to determine appropriateness of services
• Communicate determinations clearly and professionally, both verbally and in writing
• Participate in clinical discussions with external providers to clarify information and explain decisions
• Maintain strong performance across productivity, quality, and compliance metrics
• Work independently after structured onboarding while consulting with team members as appropriate
• Adapt to evolving workflows, tools, and utilization management practices
• Support a culture of collaboration, consistency, and high-quality clinical decision-making

• MD or DO degree
• Minimum of 5 years of direct patient care experience after residency or fellowship, ideally with inpatient exposure or experience treating adult/older adult populations
• Current board certification in an ABMS-recognized specialty
• Active, unrestricted medical license in at least one U.S. jurisdiction, and willingness to obtain additional licensure if needed
• No active sanctions and able to meet credentialing requirements
• Strong written and verbal communication skills
• Demonstrated analytical skills and experience working effectively within multidisciplinary teams

• Prior experience in managed care, clinical review, utilization management, or health plan operations
• Familiarity with clinical review guidelines (e.g., Inter Qual, MCG)
• Experience in hospital-based specialties such as Internal Medicine, Family Medicine, Geriatrics, Hospitalist Medicine, Emergency Medicine, or related fields
• Ability to navigate fast-paced, highly regulated environments
• Comfort using technology to support workflow efficiency
• Commitment to continuous learning, adaptability, and process improvement
• Interest in contributing to training or educational initiatives within the organization