Remote Health Plan UM Medical Director

A leading healthcare provider is seeking a Medical Director for its Health Plan, primarily remote. The ideal candidate will have over 5 years of utilization management experience and appropriate medical qualifications (MD or DO) with an active license in Massachusetts. Responsibilities include managing initial determinations and appeals, collaborating with providers, and ensuring compliance with regulatory standards. Strong communication skills and multitasking abilities are essential. This position promotes diversity and inclusion as part of its core values.