Utilization Management - Medical Director

New York Metro Area (Candidates Must Reside in NY, NJ, or CT)

Full-Time Hybrid Leadership Opportunity

Total Compensation Range: $200k - $225k

We are seeking an experienced Medical Director of Utilization Management to provide clinical leadership within a growing health plan environment serving Medicare and Medicaid populations.

This is an outstanding opportunity for a physician who enjoys collaborating across multidisciplinary teams, driving quality outcomes, ensuring regulatory compliance, and helping members receive the right care at the right time.

What You'll Do

• Serve as the physician leader and clinical resource for Utilization Management operations.
• Conduct medical necessity reviews, peer-to-peer consultations, and appeal determinations.
• Partner with executive leadership to develop and execute medical management initiativ...