Part Time Medical Director - Clinical Case Review (Friday's)

Clinical & Pharmaceutical
18248 Requisition #
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What you will get to do:

The Medical Director – Clinical Operations has the responsibilities of supporting care management, quality, utilization management, credentialing, pharmacy, health policy implementation, technology assessment and risk management activities. This position requires a solid medical and business mind, with strong judgment and investigative nature, and an ability to develop medical policy that effectively balances provider, patient, and health plan interests. This person also works to bring consistency to all aspects of the decision-making surrounding the above noted activities.


PT 1 day a week, Friday's.  Plus every 5th weekend on-call.


  • Education Level: Doctorate 
  • Medical Degree
  • 5+ years of experience in the field

Specific types of experience required:

  • Bachelors and medical degrees required
  • Must be a licensed physician with current Board certification; current license to practice must be without restrictions.
  • 5-10 years experience in health care, including leadership in a delivery system/hospital. 
  • At least five years experience in the clinical practice of medicine
  • Demonstrated proficiency in pre-service review, concurrent review, post-service review, case management and appeals (excellent case investigation skills
  • Knowledge of pharmacy and therapeutics process, including prior experience in formulary development and utilization review is very desirable

Skills & Abilities:

  • Outstanding written, verbal and communications skills 
  • Strong collaboration skills
  • Technical aptitude
  • Ability to represent Clinical on various Medica Committees
  • Strong process management skills
  • Strong ability to utilize various application technology systems
  • Excellent leadership skills 
  • Customer service orientation - must enjoy speaking to network physicians
  • Actively influences and drives discussions toward resolution - shows good judgment and decisiveness 

Certifications/Licensure: Licensed Physician; Board Certified in an ABMS

Equal Opportunity Employer Including Veterans & Disabled Individuals

Thrive Together.
At Medica, you'll enjoy working with talented people who share a mission to meet our customers' needs.
Grow Together.
Medica will support you through your personal growth and involvement in the community.
Succeed Together.
Medica provides resources that allow you to take charge of your health and career.

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