Medical Director (Texas Licensed)

TL;DR

Medical Director (Internal Medicine): Providing clinical business support and utilization management for an enterprise health platform with an accent on medication reviews, appeals, and peer-to-peer physician consultations. Focus on ensuring clinical necessity, maintaining regulatory compliance, and delivering high-quality medical decision-making within a fast-paced PBM environment.

Location: Must be based in the US and hold an active Texas medical license

Salary: $84,000–$105,000 USD

Company

hirify.global is an enterprise health technology company providing comprehensive pharmacy benefit management and health benefit administration solutions.

What you will do

• Complete medication utilization reviews and medical necessity appeals for commercial and governmental programs.
• Perform scientific literature evaluations to support clinical decision-making.
• Provide peer-to-peer phone support to prescribers regarding clinical programs and coverage policies.
• Participate in the development and revision of utilization management criteria and clinical policies.
• Maintain adherence to HIPAA guidelines and internal data security procedures.
• Participate in a shared rotating weekend on-call schedule.

Requirements

• Active Texas medical license required
• Graduate of an accredited Medical School and Residency Program.
• Board certified in Internal Medicine (MD or DO).
• Minimum 5 years of clinical practice experience with direct patient care.
• Knowledge of PBM environment, quality improvement, and managed care practices.
• Proficiency with Microsoft Office applications.

Nice to have

• Subspecialty board certification (e.g., Rheumatology, Gastroenterology).
• Active medical licenses in additional states (e.g., AZ, NC, MN, MI, TN).

Culture & Benefits

• Opportunity to work in a mission-driven enterprise health technology environment.
• Collaborative work with virtual teams of pharmacists and clinical professionals.
• Commitment to diversity and equal employment opportunity.
• Focus on professional development and maintaining current CME requirements.