Full-Time Medical Director, Utilization Management
UPMC is hiring a remote Full-Time Medical Director, Utilization Management. The career level for this job opening is Experienced and is accepting USA based applicants remotely. Read complete job description before applying.
UPMC
Job Title
Medical Director, Utilization Management
Posted
Career Level
Full-Time
Career Level
Experienced
Locations Accepted
USA
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Job Details
The UPMC Health Plan is seeking a licensed MD or DO for a fully remote Medical Director, Utilization Management role.
Responsibilities:
- Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and retrospective reviews, member grievances, provider appeals, and potential quality of care concerns.
- Provide expedited review and determination of medically pressing issues in accordance with the established policies of the Health Plan.
- Keep current with accepted standards and professional developments in the areas of quality improvement and utilization management.
- Communicate and educate network providers regarding clinical guidelines, pathways, protocols, and standards related to quality and utilization processes.
- Interacts with physicians regarding opportunities to improve member satisfaction and compliance with Utilization Management and Quality Improvement policies and procedures.
- Contributes to process improvement within the Utilization Management department.
- Participates in activities to support policy decision making. Utilizes clinical experience to support departmental reviews.
This position requires a Doctor of Medicine or Doctor of Osteopathy from an accredited school
PA Medical license Required
The ideal candidate will have 5-10 years of clinical experience, as well as managed care experience Internal Medicine, Family Medicine, or Emergency Medicine highly preferred
FAQs
What is the last date for applying to the job?
The deadline to apply for Full-Time Medical Director, Utilization Management at UPMC is
16th of December 2025
. We consider jobs older than one month to have expired.
Which countries are accepted for this remote job?
This job accepts [
USA
] applicants. .
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