Medical Director
Job
OREGON EMPLOYMENT DEPARTMENT
Salem, MA (In Person)
Full-Time
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Job Description
Job Listing ID:
4490961Job Title:
Medical Director Application Deadline:
Open Until FilledJob Location:
SalemDate Posted:
05/13/2026Hours Worked Per Week:
Not Provided Shift:
Not Provided Duration of Job:
Either Full or Part Time, more than 6 months You may contact this employer directly. (Obtain the contact information to print or add to your jobs.)Job Summary:
Medical Director Req number: R7707 Employment type: Full time Worksite flexibility: Remote Who we are CAI is a global services firm with over 9,000 associates worldwide and a yearly revenue of $1.3 billion+. We have over 40 years of excellence in uniting talent and technology to power the possible for our clients, colleagues, and communities. As a privately held company, we have the freedom and focus to do what is right-whatever it takes. Our tailor-made solutions create lasting results across the public and commercial sectors, and we are trailblazers in bringing neurodiversity to the enterprise. Job Summary We are looking for a motivated Medical Director ready to take us to the next level! If you have clinical expertise and strong decision-making skills and are looking for your next career move, apply now. Job Description We are looking for a Medical Director to ensure utilization management responsibilities are performed in accordance with the highest and most current clinical standards. This position will be Full-Time and Remote . Due to our end client, candidates must be able to work on CAI's W2 without a need for sponsorship now or in the future. What You'll Do Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer-to-peer discussions, to determine medical necessity and appropriateness Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned Compose clear and concise rationales for members and provider determination notifications while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.) Ensure that all aspects of the medical management process are consistent with community standards of care Participate as a member of the CMDM multidisciplinary team: attend huddles and grand rounds, and advise the multidisciplinary team on cases requiring physician expertise Participate in protocol and guidelines development to ensure consistency in the review process Actively manage projects and/or participate on project teams that require a physician subject matter expertWhat You'll Need Required:
Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) Awarded Board Certification at least once in a specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards Active medical state licensure required for PA, NY, or WV 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) Strong skills inCritical Thinking,Case Management,Customer Service,Oral & Written Communication,Collaboration,Listening,Telephone Skills,General Computer Skills,Clinical Software, andManaged Care Preferred:
Master's Degree in Business Administration/Management or Public Health 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry Experience with MCG or InterQual Physical Demands Ability to safely and successfully perform the essential job functions consistent with the ADA and other federal, state, and local standards Ability to conduct repetitive tasks on a computer, utilizing a mouse, keyboard, and monitor Must be able to communicate with customers/team members over the phone and in person Sedentary work that involves sitting or remaini...Job Classification:
Medical and Health Services Managers Access our statewide or regional occupation report for more information about wages, employment outlooks, skills, training programs, related occupations, and more. CompensationSalary:
Not Provided Job RequirementsExperience Required:
See Job SummaryEducation Required:
NoneMinimum Age:
N/A Gender:
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