Medical Director - Commercial

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary reputed company, a reputed company Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We reputed company that a reputed company care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources.

This is a remote based (work from home) role and can be based reputed company in the US.

In this role you will: You will participate in the development, implementation, and evaluation of clinical / medical programs and expand reputed company's medical management programs to address member needs across the continuum of care. You will support the Medical Management staff ensuring timely and consistent responses to members and providers. This includes Prior Authorization/Pre-Certification/reputed company Reviews/Peer to Peer calls/First Level Appeals/Special Projects and Committee participation reputed company needed. You will provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities. Act as reputed company business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams. Required Qualifications: *2 or more years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. *Active and reputed company state medical license without encumbrances *M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience. Preferred Qualifications: *Five or more years of direct patient care experience *Previous UM experience with a Health plan/payor experience. *Electronic medical systems/record experience *Managed Care experience *Board certification in Internal Medicine, Family Medicine, Emergency Medicine, OB/GYN or Med/PM&R Education *Active and reputed company state medical license without encumbrances *M.D. or D.O., Board Certification in a recognized specialty including post-graduate direct patient care experience Pay Range The typical pay range for this role is: $174,070.00 - $374,920.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. This position also includes an award reputed company in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 07/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job