Medical Director- Untilization Review- REMOTE Job at Momentum Resource Solutions, New York, NY

N0JRdGxzbEhMR2ExeFZ6VUNyanFBcHFPRFE9PQ==
  • Momentum Resource Solutions
  • New York, NY

Job Description

Job Description

Job Description

Medical Director- Untilization Review- REMOTE

The Medical Director is responsible for assisting in ensuring appropriate health care utilization management (UM). The Medical Director serves as a physician and policy advisor to the Plan’s Chief Medical Officer. 

80-90% of the time will be doing utilization reviews and 10-20% sitting on committees, medical policy development, fraud waste and abuse investigations. If you speak to someone who is working as a physician, ask them why they want to transition into UM work.

  • Must have MD and board certified
  • Need to have experience with Utilization Management Reviews
  • Plus: Pediatrician
  • Plus: Managed Care experience
  • Plus: InterQual experience
  • 100% remote
  • Needs to be licensed in NY

 

Job Tags

Remote job,

Similar Jobs

Petco Animal Supplies, Inc.

DC Coordinator Job at Petco Animal Supplies, Inc.

 ...you want to make a real difference, create an exciting career path, feel welcome to be your whole self and nurture your wellbeing, Petco is the place for you. Our core values ca Coordinator, Warehouse Worker, Internet, Monitoring, Total Rewards, Regulatory, Management,... 

PRS Management, Inc.

Payroll Assistant Job at PRS Management, Inc.

 ...Overview Capitol Lakes is looking for a Part-Time Payroll Assistant to ensure accurate and timely completion of payroll for all employees at Capitol Lakes in conjunction with our accounting and human resources team. You will oversee biweekly payroll processing... 

Whitney Museum of American Art

Joan Tisch Teaching Fellows Job at Whitney Museum of American Art

 ...offers graduate students pursuing advanced degrees in art and art history the unique opportunity to work directly with the Whitney Museum's collection and audiences within a community of academic support. Participants in the program design specialized tours both in-gallery... 

Della Infotech

Locum - Physician - OBGYN Ontario OR Job at Della Infotech

 ...coverage, beeper callLocums will NOT be responsible for supervising other providersEMR: EPICLevel II TraumaClient will reimburse for travel*Please Note: Trinity Health does not reimburse for any application or credentialing fees.Please make sure you have the following... 

Sazerac Company

Safety Coordinator Job at Sazerac Company

 ...growth with competitive salaries and benefits in an exciting, entrepreneurial industry. Job Description/Responsibilities: The Safety Coordinator leads the safety culture for 1820 Spirits; leads the development and execution of a sound safety program to achieve...