Senior Utilization Review Medical Director

The Senior Utilization Review Medical Director serves as the clinical and strategic leader for Integra’s Utilization Management (UM) and Credentialing programs. This is a full-time, 40+ hour per week leadership role that requires consistent availability standard business hours, with additional availability as operational needs require.

Requirements

• MD or DO degree
• Board certification in Internal Medicine, Family Medicine, Emergency Medicine, PM&R, or another relevant specialty
• Active, unrestricted medical license
• Eligible for participation in Medicare, Medicaid, and all federally funded programs; no OIG sanctions
• 5+ years of utilization management experience, including complex case review
• Prior leadership experience overseeing clinical staff or UM operations
• Experience with NCQA UM and Credentialing accreditation standards
• Strong knowledge of Medicare, Medicaid, and DMEPOS regulatory requirements
• Exceptional written and verbal communication skills including documentation clarity
• Experience as a health plan medical director
• Experience with DMEPOS UM programs, MLTC, Medicaid, or Medicare Advantage
• Experience chairing or participating in UM, Credentialing, or clinical governance committees
• Experience developing medical policies or clinical criteria
• Experience representing an organization to external medical leadership at health plans

Benefits

• Competitive compensation and annual bonus program
• 401(k) retirement program with company match
• Company-paid life insurance
• Company-paid short term disability coverage (location restrictions may apply)
• Medical, Vision, and Dental benefits
• Paid Time Off (PTO)
• Paid Parental Leave
• Sick Time
• Paid company holidays and floating holidays
• Quarterly company-sponsored events
• Health and wellness programs
• Career development opportunities