Senior Medical Director (Healthcare)

Location: Remote in New Hampshire; must be located in New Hampshire or willing to relocate to New Hampshire.

Salary: $215,000–$408,500 per year

Company

hirify.global provides health plan services focused on improving access to effective and affordable healthcare.

What you will do

• Assist the Vice President of Medical Affairs in directing and coordinating medical affairs functions.
• Lead utilization management, pharmacy, case management, disease management, cost containment, and medical quality improvement activities.
• Perform medical reviews involving complex, controversial, experimental, or unusual services and determine medical necessity and appropriate payment.
• Oversee the Appeals and Denials department, physician advisors, and other medical directors.
• Represent the health plan with the New Hampshire Department of Health and Human Services, at state fair hearings, and in clinical escalations.
• Support provider performance improvement, network development, physician education, committees, and quality initiatives.

Requirements

• Medical Doctor or Doctor of Osteopathy degree.
• 7+ years of clinical experience practicing medicine and active medical practice.
• Board certification recognized by the American Board of Medical Specialists or the American Osteopathic Association.
• Current unrestricted state license as an MD or DO, without government-program restrictions, limitations, or sanctions.
• Managed care or ACO leadership, management, utilization management, and quality accreditation experience are preferred.
• Active board certification in Internal Medicine or Family Medicine is preferred.

Culture & Benefits

• Remote, hybrid, field, or office work schedules may be available depending on role and eligibility.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible hours may include weekends and holidays to maintain staffing and patient-care coverage.
• Work supports healthcare access and quality for individuals, families, and communities.