Associate Medical Director - Health Services UM & Virtual Support

Location: United States; Remote. Work from home with a designated work area, company-provided equipment, and a reliable internet connection with at least 50 Mbps download and 10 Mbps upload speeds.

Salary: $90–$110 per hour, part-time

Company

hirify.global provides health services, utilization management, clinical quality management, and virtual healthcare support.

What you will do

• Make medical management and medical necessity review decisions for physical therapy, occupational therapy, speech therapy, athletic training, chiropractic, and acupuncture services.
• Support delegated appeals processes and provide medical decision-making for clinical quality and utilization management programs.
• Conduct utilization management file reviews while meeting quality, productivity, and turnaround-time requirements.
• Provide virtual telehealth medical support and clinical consultation for virtual programs.
• Support training, auditing, credentialing, quality assurance, quality improvement, and special clinical projects.
• Participate in clinical committee meetings and collaborate with medical directors and clinical and operational leadership.

Requirements

• Current, unrestricted medical or osteopathic license in the United States and willingness and ability to obtain and maintain licenses in additional states as requested.
• Graduate of an accredited medical college in the United States and board certification.
• At least five years of clinical practice experience.
• Experience in utilization management, medical necessity review, provider discussions related to utilization management decisions, and clinical quality assurance or quality management.
• Experience in musculoskeletal medicine and/or knowledge of physical therapy.
• Excellent computer, communication, organizational, analytical, and interpersonal skills, with the ability to maintain confidentiality.

Nice to have

• Experience as a medical director for a full-service medical health plan or insurance company.
• General understanding of complementary healthcare.

Culture & Benefits

• Remote training and work-from-home environment.
• Company-provided technology equipment.
• Collaboration with clinical and operational leadership and medical directors.
• Primarily sedentary work with the ability to work using a computer, telephone, keyboard, and mouse.