Remote Medical Director, Inpatient Medicare

Location: Remote-MO; remote work within the United States

Salary: $236,500–$449,300 per year

Company

hirify.global is a national healthcare organization serving 28 million members through health services and medical management programs.

What you will do

• Assist the Chief Medical Director in directing medical management, utilization management, quality improvement, and credentialing functions.
• Conduct medical reviews for utilization, quality assurance, complex or controversial services, medical necessity, and appeals.
• Lead or support performance improvement initiatives for capitated providers and identify adverse utilization trends and unusual practice patterns.
• Conduct regular rounds for high-risk patients and coordinate care with care management teams.
• Collaborate with clinical teams, network providers, appeals teams, and medical and pharmacy consultants.
• Support physician committees, provider network development, market expansion, and physician education.

Requirements

• Medical Doctor or Doctor of Osteopathy degree.
• Active medical practice and a current unrestricted MD or DO state license without government-program restrictions, limitations, or sanctions.
• Board certification in a specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association’s Department of Certifying Board Services.
• Active American Board Certification in Internal Medicine or Family Medicine is preferred.
• Utilization Management experience and knowledge of quality accreditation standards are preferred.
• Experience treating or managing care for culturally diverse populations is preferred.

Culture & Benefits

• Remote, hybrid, field, and office work schedules are supported, with this role listed as remote in Missouri.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays are offered.
• Weekend and holiday work may be required to support business operations.
• Compensation may vary based on skills, experience, education, and other job-related factors.