Medical Director/30/MCO005

The Judge Group
November 25, 2021
Atlanta, GA
Job Type


Location: REMOTE
Description: Our client is currently seeking a Medical Director

Medical Director will provide utilization management services for our clients and clinical guidance for our next-generation comprehensive specialty pharmacy solution. This solution will help ensure providers deliver high-quality, evidence-based and cost-efficient specialty pharmacy care for our clients.
Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
? Serve as a subject matter expert in specialty pharmacy drugs covered under the medical benefit to include for example sodium hyaluronate, inflammatory, intravenous immunoglobulin and multiple sclerosis drugs
? Perform utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes
? Engage & collaborate with treating providers telephonically. This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense
? Enhance clinical expertise of the specialty pharmacy team through education sessions with nursing teams
? Evaluate clinical and other data (e.g., quality metrics, claims & health record data, utilization data) to identify opportunities for improvement of clinical care and processes
At Optum, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
Required Qualifications:
? MD or DO with an active, unrestricted medical license
? Board Certified in a Medical Specialty
? 5+ years of clinical practice experience
? Demonstrated accomplishments in any of the following areas: Utilization management, Case management, Disease management, Quality management
? Experience working with clinical policy
? Strong presentation skills and interpersonal skills
? Strong computer skills to include MS Office and the ability to learn new technologies
Preferred Qualifications:
? Utilization management experience working in collaboration with a utilization management company, payor or hospital
? Internal Medicine, Family Medicine

Contact: [Click Here to Email Your Resumé]

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