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The Judge Group

Medical Director (utilization management)

The Judge Group, New York, New York, United States

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Medical Director (Remote – US Only) Type:

6‑month contract with potential for hire Schedule:

Full-time (40 hours/week) with rotating weekend coverage Reports To:

Lead Medical Director

About the Role We are seeking experienced, board-certified physicians to join our team as

Medical Directors . In this role, you will

review clinical documentation, assess complex medical scenarios, and issue expert determinations on requested healthcare services . You will collaborate with external providers by phone to gather additional clinical information and discuss decisions. Successful Medical Directors thrive in a structured, team-based environment, demonstrate strong clinical judgment, communicate clearly, and uphold a high standard of professionalism, integrity, and compliance.

Key Responsibilities Conduct comprehensive, timely, and compliant

medical necessity reviews

for inpatient services. Apply national clinical guidelines, CMS requirements, organizational policies, and relevant contracts in decision-making. Maintain accountability for

productivity, quality, and compliance

metrics. Participate in rotating weekend coverage to ensure timely case completion. Communicate determinations clearly in both written and verbal formats. Collaborate with peers and external healthcare providers to support consistent, high‑quality outcomes. Demonstrate adaptability in adopting new workflows, tools, and utilization management practices. Work independently after training while having access to team support as needed.

Required Qualifications MD or DO degree. 5+ years

of post‑residency or fellowship clinical experience, preferably with inpatient exposure or care of Medicare‑aged or disabled populations. Current and ongoing

ABMS board certification

in an approved medical specialty. Experience in

managed care

settings (Medicare Advantage, Managed Medicaid, Commercial plans). Prior

utilization management

experience (payer, review organization, or integrated delivery system). Familiarity with national guidelines such as

MCG®

or

InterQual . Active, unrestricted medical license in at least one US jurisdiction; ability to obtain additional licensure if needed. No sanctions from federal or state governmental bodies; able to pass credentialing. Strong verbal and written communication skills. Demonstrated analytical and interpretive abilities; experience working collaboratively in team settings.

Preferred Qualifications Background in hospital-based specialties such as Internal Medicine, Family Medicine, Geriatrics, Hospitalist Medicine, Emergency Medicine, or related fields. Ability to adapt to fast-paced, dynamic workflows and contribute to innovation. Proficiency with technology to optimize clinical review processes. Willingness to participate in educational activities, including presenting or developing clinical content. Strong commitment to consistency, quality outcomes, consumer experience, and team engagement.

Interview Process All interviews conducted

virtually via Zoom . One interview

with the Lead Medical Director, followed by hiring decision.