What are the responsibilities and job description for the Medical Director position at IntePros?
Medical Director - Utilization Review
The Physician leader is responsible for advancing the delivery of safe, high-quality, and cost-effective medical care across multiple health plan offerings. This role provides clinical leadership and expertise to support Utilization Management, Care Management, and related business functions where physician involvement is essential to achieving optimal outcomes.
Key Responsibilities
- Provide physician leadership and clinical guidance to Utilization Management and Care Management functions
- Render coverage and payment determinations in accordance with health plan benefits, medical policies, and provider contracts
- Apply evidence-based clinical guidelines and best practices to support consistent, high-quality decision-making
- Exercise informed medical judgment grounded in clinical medicine, patient safety, quality management, and population health principles
- Collaborate effectively with clinical teams, operational leaders, senior management, and external partners
- Promote efficient, cost-effective care delivery across all lines of business
- Support organizational initiatives related to quality improvement, compliance, and healthcare outcomes
Required Qualifications & Experience
- Medical Doctor (MD) or Doctor of Osteopathy (DO) from an accredited medical or osteopathic medical school recognized by AAMC, AOA, or WHO
- Unrestricted and active Pennsylvania medical or osteopathic license
- Current board certification through ABMS or AOBMS (Family Medicine or Internal Medicine preferred)
- Ability to successfully complete organizational credentialing requirements
- Strong knowledge of Utilization Management, healthcare delivery systems, and payer-based medical decision-making
Work Location
- Fully Remote: This position is designated as fully remote
- Candidate must reside within the Tri-State Area (Pennsylvania, New Jersey, or Delaware)
Salary : $140 - $150