Lead Medical Director, Utilization Management

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

This is a senior physician leadership opportunity focused on ensuring members receive appropriate, timely, and evidence-based healthcare. You will oversee utilization management activities, providing clinical direction for medical necessity reviews across outpatient referrals, inpatient admissions, and other care requests. Alongside managing a team of Utilization Management Medical Directors, you will help shape clinical policies, strengthen review consistency, and guide complex or escalated cases. You will play a key role in multidisciplinary committees, collaborating with clinical, quality, compliance, pharmacy, and operational teams. By using clinical evidence, case trends, and performance data, you will identify opportunities to improve care quality, access, and outcomes. This remote-first role combines hands-on clinical judgment, strategic leadership, and a strong commitment to member-centered care.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether?    Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.     #LI-CL1