Remote Inpatient Medicare Medical Director (Medicare)

Location: Remote-MO, United States

Salary: $236,500–$449,300 per year

Company

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

What you will do

• Assist the Chief Medical Director with medical management, quality improvement, credentialing, and business-unit policy initiatives.
• Lead utilization management, cost-containment, medical quality improvement, and complex medical necessity review activities.
• Conduct 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 on complex cases and appeals.
• Evaluate utilization trends, provider practice patterns, claims, benefit components, and opportunities to reduce unwarranted clinical variation.
• Support provider education, network development, market expansion, physician committees, and external medical representation.

Requirements

• Medical Doctor or Doctor of Osteopathy degree.
• Active practice of medicine and a current unrestricted MD or DO state license without government-program sanctions.
• Board certification in a specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association.
• Active American Board Certification in Internal Medicine or Family Medicine is preferred.
• Utilization Management experience and knowledge of quality accreditation standards are preferred.
• Availability to work weekends and holidays may be required to support business operations.

Culture & Benefits

• Remote, hybrid, field, and office work schedules are supported.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Compensation is adjusted according to skills, experience, education, job-related factors, and employment status.
• Additional incentive compensation may be available, subject to eligibility.