REMOTE - Quick Start - Medical Director - Primary Care - Pennsylvania License Required
Updated 12/18/25
Philadelphia, Pennsylvania, United States
Physician
Medical Director
By applying you agree to our Terms of Service
Job at a glance
Degree Required
MD/DO
Position Type
Full-Time
Moonlighting
Locums/Travel
Part-Time/Contract
Work Environment
Hospital
Telemedicine
Inpatient
Visa Sponsorship
No
Job description
Job description
***This role has no credentialing since its non-patient facing
***ASAP start.
**Mostly conducting managed care utilization reviews
Essential Functions:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Perform utilization review for requests for services including but not limited to inpatient, outpatient, pharmacy and dental. This will include peer-to-peer discussions with providers.
• Serve on and support the functions of committees including but not limited to the Utilization Management Committee and Pharmacy & Therapeutics Committee.
• Advise the HealthCare Senior Management team regarding the utilization of health care services and interventions to promote the effective delivery of medically necessary services.
• Participate and/or lead rounds including but not limited to disease management, care management or admissions.
• Provide support for Plan accreditation processes (NCQA), Utilization, Quality and Disease Management programs.
• Support ongoing activities in OB, pediatric, adolescent, adult preventative, and geriatric care.
• Develop and or revise practice guidelines for acute and chronic care.
• Develop and implement policies and procedures required to promote effective utilization management and achieve established targets.
• Collaborate with HealthCare Economics and Finance to continuously improve the collection and use of data describing resource utilization and outcomes.
• Represent HealthCare Management internally and externally at the direction of the VP Chief Medical Officer.
• Develop and implement work plans to optimize appropriate utilization and quality targets as directed by the VP Chief Medical Officer.
• Perform other job duties as assigned.
Required Education and Experience:
• Medical Physician (MD or DO) required.
• Pennsylvania Medical License without restriction.
• Board Certification in a specialty (primary care preferred)
• Graduate business degree is a plus (MBA, MMM, etc.).
• Minimum 5 years post-residency experience in the clinical practice of medicine.
• Managed care experience, with responsibility for utilization management.
Skills/Abilities:
• Excellent organizational, interpersonal, time management and communications skills.
• Strong leadership skills.
• Strong conflict resolution and independent decision-making skills.
• Expert project management ability.
• Strong influencing, negotiation and analytical skills.
• Working knowledge of PC based applications such as Excel, Access and Word.
• Knowledge of the principles of Utilization, Quality and Care Management.
***ASAP start.
**Mostly conducting managed care utilization reviews
Essential Functions:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Perform utilization review for requests for services including but not limited to inpatient, outpatient, pharmacy and dental. This will include peer-to-peer discussions with providers.
• Serve on and support the functions of committees including but not limited to the Utilization Management Committee and Pharmacy & Therapeutics Committee.
• Advise the HealthCare Senior Management team regarding the utilization of health care services and interventions to promote the effective delivery of medically necessary services.
• Participate and/or lead rounds including but not limited to disease management, care management or admissions.
• Provide support for Plan accreditation processes (NCQA), Utilization, Quality and Disease Management programs.
• Support ongoing activities in OB, pediatric, adolescent, adult preventative, and geriatric care.
• Develop and or revise practice guidelines for acute and chronic care.
• Develop and implement policies and procedures required to promote effective utilization management and achieve established targets.
• Collaborate with HealthCare Economics and Finance to continuously improve the collection and use of data describing resource utilization and outcomes.
• Represent HealthCare Management internally and externally at the direction of the VP Chief Medical Officer.
• Develop and implement work plans to optimize appropriate utilization and quality targets as directed by the VP Chief Medical Officer.
• Perform other job duties as assigned.
Required Education and Experience:
• Medical Physician (MD or DO) required.
• Pennsylvania Medical License without restriction.
• Board Certification in a specialty (primary care preferred)
• Graduate business degree is a plus (MBA, MMM, etc.).
• Minimum 5 years post-residency experience in the clinical practice of medicine.
• Managed care experience, with responsibility for utilization management.
Skills/Abilities:
• Excellent organizational, interpersonal, time management and communications skills.
• Strong leadership skills.
• Strong conflict resolution and independent decision-making skills.
• Expert project management ability.
• Strong influencing, negotiation and analytical skills.
• Working knowledge of PC based applications such as Excel, Access and Word.
• Knowledge of the principles of Utilization, Quality and Care Management.
By applying you agree to our Terms of Service