Physician Medical Director

Judge Group

(remote)

JOB DETAILS
SALARY
$125–$150 Per Year
SKILLS
Business Administration, Clinical Study Publications, Communication Skills, Consulting, Cross-Functional, Customer Escalations, Drug Development, Health Insurance, Health Plan, Maintain Compliance, Managed Care, Patient Care, Patient Care Authorizations, Short Messaging Service (SMS), Team Player, United States Citizen, Utilization Management
POSTED
6 days ago
Location: REMOTE
Salary: $125.00 USD Hourly - $150.00 USD Hourly
Description:

Job Title: Medical Director – Utilization Management (Contract to Hire)

Location: Fully Remote (U.S. Only)
Work Authorization: U.S. Citizen required


Overview

Seeking experienced Medical Directors with payer-side utilization management experience to support high-volume medical necessity reviews. This is a contract-to-hire opportunity working within a structured, compliance-driven environment.


Key Details

  • Contract: 6/1/2026 – 12/31/2026 (potential to convert)
  • Schedule: 40 hours/week
    • Core: 9am–5pm EST (flexible after training))

What You’ll Do

  • Review escalated cases against medical policy criteria to determine medical necessity
  • Complete initial determinations, appeals, and grievance reviews
  • Conduct peer-to-peer calls when required
  • Write clear, compliant clinical rationales
  • Participate in multidisciplinary team discussions (case reviews, rounds)
  • Support guideline development and clinical projects

Volume / Tools

  • Expected throughput: 55+ cases per day
  • Systems: Predictal, Beacon

Required Qualifications

  • MD or DO
  • Board Certified (ABMS or AOA)
  • 5+ years direct patient care experience
  • Active, unrestricted license in PA, NY, or WV
  • Strong clinical judgment, documentation, and communication skills
  • Managed care / utilization management knowledge required

Critical Requirement (Will Screen Heavily)

  • Must have payer-side utilization management experience
    • Health plan / insurance experience required
    • Hospital-only UM experience will not be considered

Preferred

  • Experience with MCG or InterQual
  • Prior health plan medical management experience
  • MBA, MHA, or MPH

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    Contact: elandes@judge.com
    This job and many more are available through The Judge Group. Find us on the web at www.judge.com

    About the Company

    J

    Judge Group

    The Judge Group Inc., is a leading professional services firm specializing in talent, technology, and learning solutions. We consult, staff, train, and solve. Through our work we make people and organizations better. Our services are successfully delivered through a network of more than 30 offices across the United States, Canada, and India.

    The Judge Group is proud to partner with the best and brightest companies in business today, including over 60 of the Fortune 100. We serve organizations in financial services, healthcare, life sciences, insurance, government (including aerospace and defense), manufacturing, and technology and telecommunications. If you would like to learn more about The Judge Group visit www.judge.com or call toll free (800) 360-4474.

    COMPANY SIZE
    5,000 to 9,999 employees
    INDUSTRY
    Computer/IT Services
    FOUNDED
    1970
    WEBSITE
    https://www.judge.com