Medical Director - OP Medicare

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Medical Director - OP Medicare based in United States.

• This is a remote physician leadership role focused on complex outpatient utilization management for Medicare populations.
• You will apply clinical expertise and medical judgment to evaluate authorization requests, medical necessity, level of care, and site-of-service decisions.
• The role combines independent clinical review with collaboration across physicians, care management, analytics, and other healthcare teams.
• You will use clinical guidelines, CMS requirements, Medicare policies, and internal standards to support consistent, evidence-based determinations.
• Beyond case review, the position offers opportunities to contribute to care management, appeals, clinical documentation, and population health initiatives.
• The environment emphasizes sound judgment, regulatory compliance, operational excellence, and continuous improvement.
• This role is well suited to an experienced physician interested in applying clinical expertise beyond direct patient care while influencing care quality at scale.