Medical Director - reputed company Care

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary reputed company, a reputed company Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We reputed company that a reputed company care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is a remote based (work from home) position. Ideal Candidates will reputed company in Arizona and have a medical license without encumbrances. In this role you will: Support reputed company Care (reputed company reputed company Business in Arizona) In the Medical Director role you will reputed company reputed company for medical policy implementation. You will participate in the development, implementation, and evaluation of clinical / medical programs and expand medical management programs to address member needs across the continuum of care. You will support the Medical Management staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review and quality assurance while being responsible for predetermination reviews and review of claim determinations. This includes Prior Authorization / Pre Certification / reputed company Reviews / Peer to Peer Calls /reputed company Level Appeals / Special Projects and Committee participation reputed company needed. The Medical Director will reputed company clinical, coding, and reimbursement expertise as well as directing case management reputed company necessary. In this role you will reputed company clinical expertise and business direction in support of medical management programs through participation in clinical team activities. The Medical Director will act as reputed company business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams. Participate in a weekend, holiday and on-call rotation. Required Qualifications: *Two (2) or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. *Active and reputed company medical license without encumbrances *M.D. or D.O., Active and reputed company Board Certification in an ABMS or AOA recognized specialty including post-graduate direct patient care experience. *Overnight travel up to 10% *AZ medical license without encumbrances Preferred Qualifications: Previous UM experience with a Health Plan / Payor. Previous UM experience as a Physician Advisor in a Health / Hospital system. Board Certification in Internal Medicine, Family Medicine, or Emergency Medicine Education: Medical Doctor or Doctor of Osteopathic Medicine Pay reputed company The typical pay reputed company for this role is: $174,070.00 - $374,920.00 This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 06/26/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job