Remote National Medical Director

Location: Remote-MO; requires a current unrestricted medical license in a state

Salary: $236,500–$449,300 per year

Company

hirify.global connects people with healthcare services and works to make care more accessible and effective.

What you will do

• Support the Chief Medical Director in leading medical management, utilization management, cost containment, quality improvement, and credentialing activities.
• Conduct medical reviews for complex, controversial, experimental, unusual, or new services and determine medical necessity and appropriate payment.
• Coordinate care for high-risk patients and collaborate with care management teams, clinical teams, providers, appeals teams, and medical and pharmacy consultants.
• Support performance improvement initiatives for capitated providers and identify adverse utilization trends, unusual practice patterns, and opportunities to improve care quality and cost-effectiveness.
• Participate in physician committees, provider network development, new market expansion, physician education, and state or ad hoc committees.
• Represent the business unit on medical philosophy, policies, quality, and utilization-related matters when needed.

Requirements

• Medical Doctor or Doctor of Osteopathy degree.
• Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• Current MD or DO license without restrictions, limitations, or sanctions from government programs.
• Active medical practice.
• Utilization management experience and knowledge of quality accreditation standards are preferred.
• Experience treating or managing care for culturally diverse populations is preferred.

Culture & Benefits

• Full-time employment with a flexible remote work approach.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Work may include weekends and holidays when required by business operations.
• Commitment to diversity and equal employment opportunity.