We are currently searching for a board-certified psychiatry physician to become the Medical Director of Utilization Management in San Diego California. This is an exceptional opportunity to manage patient outcomes for commercial and government health plans in CA. 100% Remote role.

Primary duties may include, but are not limited to:

Interprets existing policies and develops new policies based on changes in the healthcare or medical arena. You will lead, develop, direct and implement clinical and non-clinical activities that impact health care quality cost and outcomes. The director will identify and develop opportunities for innovation to increase effectiveness and quality.

The medical director will serve as a resource and consultant to other areas of the company, may chair or serve on company committees, may be required to represent the company to external entities and/or serve on external committees, conduct peer clinical and/or appeal case reviews and peer to peer clinical reviews with attending physicians or other ordering providers to discuss review determinations, provides guidance for clinical operational aspects of the program. The director will also support the medical management staff ensuring timely and consistent responses to members and providers.

To qualify you must be a board-certified psychiatrist by American Board of Psychiatry and Neurology. Must possess an active unrestricted medical license to practice medicine in the state of California. Have 10 years of clinical experience or any combination of education and experience, which would provide an equivalent background. Utilization Management experience a plus. And experience with substance use preferred.
For more information and to schedule an interview please send your CV via e-mail. ADV/9-19