Physician Medical Director
The Judge Group
Remote
Posted on Jun 4, 2026
*** REMOTE OPPORTUNITY ***
The Judge Group is hiring experienced Medical Directors for remote positions with payer-side utilization management experience to support high-volume medical necessity reviews. This is a contract-to-hire opportunity working within a structured, compliance-driven environment.
Key Details
- Contract with end date of 12/31/2026 and with potential to convert
- Schedule: 40 hours/week
- Core: 9am–5pm EST (flexible after training)
Responsibilities
- Review escalated cases against medical policy criteria to determine medical necessity
- Complete initial determinations, appeals, and grievance reviews
- Conduct peer-to-peer calls when required
- Write clear, compliant clinical rationales
- Participate in multidisciplinary team discussions (case reviews, rounds)
- Support guideline development and clinical projects
Volume / Tools
- Expected throughput: 55+ cases per day
- Systems: Predictal, Beacon
Required Qualifications
- MD or DO
- Board Certified (ABMS or AOA)
- 5+ years direct patient care experience
- Active, unrestricted license in PA, NY, or WV
- Managed care / utilization management knowledge
Critical Requirement
- Must have payer-side utilization management experience
- Health plan / insurance experience required
- Hospital-only UM experience will not be considered
Preferred Qualifications
- Experience with MCG or InterQual
- Prior health plan medical management experience
- MBA, MHA, or MPH
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