Medicare Medical Director: Utilization & Quality Oversight

Job description

Molina Healthcare is seeking a Medical Director to oversee medical necessity determinations and utilization management for plan members, ensuring high-quality, cost-effective care across networks and settings.

Responsibilities include leading clinical policy development, coordinating with providers and network managers, and guiding NCQA/URAC accreditation readiness while maintaining regulatory standards and member satisfaction.

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Who can apply

Review the original listing for work authorization, qualifications and employer requirements.