Overview A large managed care company is seeking a dedicated Medical Program Director to lead utilization management efforts, analyze trends, and identify opportunities for service optimization. Join us in enhancing our utilization management program and making a meaningful impact on health plan members' care. Work Location WORK LOCATION: FULLY REMOTE Compensation PAY: $115.00 Contract Dates CONTRACT DATES: 9/15/25 - 12/15/25 Hours HOURS: M-F, 8-5. Flexibility to include evening hours is required. Responsibilities Develop and maintain an efficient Utilization Management (UM) program aligned with the needs of health plan members and company values. Engage in case reviews and make medical necessity determinations. Conduct post-service reviews for medical necessity and benefits coding. Contribute to the establishment of medical management, care management, and UM protocols. Oversee compliance of physicians with the UM plan. Provide quality assurance and educate staff on contemporary medical technologies, review criteria, and UM policies, as well as guidance when criteria are not met. Qualifications Master's degree. Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), or M.B.B.S. degree. Board certification in Family Medicine or Internal Medicine. An active, unrestricted medical license in any state. A minimum of five years of post-residency clinical practice experience. Proficiency with Microsoft Office applications. Preferred: Two or more years of experience in utilization management activities. Preferred: Two or more years of experience with acute admissions. Preferred: Two years of experience in a managed care health plan environment. Preferred: Experience as a hospitalist. Preferred: Bilingual fluency in English and Spanish.