Medical Director, Utilization Management (Commercial & MA)

Medical Director, Utilization Management (Commercial & MA)

Overview

Are you a physician leader looking for a meaningful way to shape healthcare delivery from the comfort of your home office? Bickham Services Unlimited LLC is seeking a dedicated Medical Director for Utilization Management to join our team on a contract basis. This is a fully remote opportunity open to qualified professionals worldwide, offering a chance to drive clinical integrity for Commercial and Medicare Advantage populations. Running from August 2026 through February 2027 with potential for extension, this role lets you make a massive impact right away.

Key Responsibilities

  • Lead and support the clinical integrity of utilization management functions with a strong focus on inpatient and post-acute care reviews.
  • Ensure timely, consistent, and appropriate care determinations for members using applicable benefit plans and medical policies.
  • Evaluate medical necessity while strictly adhering to CMS regulations, clinical criteria, and evidence-based medicine practices.
  • Collaborate closely with the Chief Medical Officer and other clinical teams to streamline operations and elevate overall care standards.

Requirements

  • Must hold an active, unrestricted medical license and demonstrate a strong background in clinical practice.
  • At least five years of overall clinical experience is required for this position.
  • Minimum of three years of hands-on experience in utilization management, physician review, or medical leadership within a managed care or health plan setting.
  • Deep familiarity with both Commercial and Medicare Advantage programs.

What You'll Gain

  • The ultimate flexibility of working 100 percent remotely from anywhere in the world.
  • A collaborative environment where your medical expertise directly influences patient outcomes.
  • Valuable leadership exposure working directly alongside top executive medical personnel.

How to Apply

Click the apply button below to view the full job details and submit your application directly through the employer's official page.

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