You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Medical Director for Physical Health Medical Management. This critical role provides clinical oversight, medical expertise, and operational support, ensuring the highest standards of medical review processes and supporting clinical quality, utilization management, and care coordination goals.

Key Responsibilities

• Provide expert guidance and oversight for physical health service requests, including authorization of services and determination of appropriate level of care.
• Ensure the integrity and quality of utilization management activities for inpatient and outpatient services.
• Participate in internal reviews of clinical case types to ensure compliance with regulatory and organizational standards.
• Review and approve or deny services and level of care requests based on established criteria.
• Support the Clinical Operations Department through active participation in organizational committees.
• Participate in mediation activities and provide clinical expertise as required.
• Maintain awareness of regulatory requirements and contribute to process improvement initiatives.
• Train and mentor peers within the Medical Management team.
• Work closely with Human Resources to maintain a qualified workforce and promote an inclusive working environment.

Qualifications

• Graduation from an accredited Medical School. M.D./D.O. degree is required and board certification in a relevant field.
• At least four (4) years of postgraduate clinical experience and two (2) or more years of managed care and utilization management experience.
• Current, active, and unrestricted license to practice medicine in North Carolina or meets qualifications for a North Carolina Medical License.

Skills

• Knowledge of diagnosis and treatment of medical issues.
• Knowledge of Managed Care Principles and recent developments in the field of medicine.
• Proficiency in Microsoft Office.
• Strong communication skills for treatment concerns and complex case issues.
• Experience in utilization management.

Additional Requirements

• Ability to work some weekends and holidays based on organizational needs.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

This position complies with all applicable employment laws and regulations. Equal employment opportunity employer.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

Any required state or Joint Commission training is compensated at the state or local minimum wage rate.

^*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.