Medical Director

Job not on LinkedIn

October 16

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

🦌 Connecticut – Remote

Although this job is listed in Connecticut, this company may be open to hiring remote in other states.

+2 more states

🏄 California – Remote 🦌 Connecticut – Remote 🦬 Montana – Remote

💵 $263.5k - $329.4k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

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Mosaic

WebsiteLinkedInAll Job Openings

Healthcare Insurance • Fintech • B2C

Mosaic is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans.

1001 - 5000 employees

Founded 1913

⚕️ Healthcare Insurance

💳 Fintech

👥 B2C

📋 Description

• Lead the development, implementation, and periodic review of UM policies and clinical criteria • Provide physician oversight for concurrent and retrospective review activities • Approve and interpret clinical guidelines, pathways, and criteria for admission, continued stay, and discharge • Serve as the primary clinical liaison with payers, providers, and regulatory bodies • Mentor and educate UM nurses, physician reviewers, and other staff on best practices • Analyze utilization data and quality metrics to identify trends and areas for improvement • Participate in appeals and peer-to-peer discussions to resolve clinical disputes • Maintain compliance with NCQA, URAC, CMS, state regulations, and organizational standards

🎯 Requirements

• Medical degree (MD or DO) from an accredited institution • Active, unrestricted medical license in [State/Region] • Board certification in an acute-care specialty (e.g., Internal Medicine, Family Medicine, Pediatrics) • Minimum of 5 years clinical practice experience, with 2+ years in utilization management or managed care

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development • Bonuses