Pyramid Consulting
Pyramid Consulting, Inc provided pay range
This range is provided by Pyramid Consulting, Inc. Your actual pay will be based on your skills and experience talk with your recruiter to learn more. Base pay range
$125.00/hr - $140.00/hr Immediate need for a talented
Medical Director . This is a
06+ Months Contract
opportunity with long-term potential and is located in
U.S.(Remote) . Please review the job description below and contact me ASAP if you are interested. Job ID:25-81263 Pay Range: $125 - $140/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. "Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. Supports effective implementation of performance improvement initiatives for capitated providers. Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes. Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies. Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment. Develops alliances with the provider community through the development and implementation of the medical management programs. As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues. Represents the business unit at appropriate state committees and other ad hoc committees. May be required to work weekends and holidays in support of business operations, as needed. Key Requirements and Technology Experience: Skills- Utilization Management, MD and Doctor of osteopathy Medical Doctor or Doctor of Osteopathy. Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Associations Department of Certifying Board Services. Our client is a leading
Healthcare Industry
and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here. Seniority level
Seniority level
Not Applicable Employment type
Employment type
Contract Job function
Job function
Information Technology Industries
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This range is provided by Pyramid Consulting, Inc. Your actual pay will be based on your skills and experience talk with your recruiter to learn more. Base pay range
$125.00/hr - $140.00/hr Immediate need for a talented
Medical Director . This is a
06+ Months Contract
opportunity with long-term potential and is located in
U.S.(Remote) . Please review the job description below and contact me ASAP if you are interested. Job ID:25-81263 Pay Range: $125 - $140/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. "Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. Supports effective implementation of performance improvement initiatives for capitated providers. Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Conduct regular rounds to assess and coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes. Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies. Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment. Develops alliances with the provider community through the development and implementation of the medical management programs. As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues. Represents the business unit at appropriate state committees and other ad hoc committees. May be required to work weekends and holidays in support of business operations, as needed. Key Requirements and Technology Experience: Skills- Utilization Management, MD and Doctor of osteopathy Medical Doctor or Doctor of Osteopathy. Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Associations Department of Certifying Board Services. Our client is a leading
Healthcare Industry
and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration. Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here. Seniority level
Seniority level
Not Applicable Employment type
Employment type
Contract Job function
Job function
Information Technology Industries
Hospitals and Health Care Referrals increase your chances of interviewing at Pyramid Consulting, Inc by 2x Get notified about new Medical Director jobs in
United States . United States $325,000.00-$350,000.00 3 days ago Los Angeles, CA $275,000.00-$300,000.00 3 weeks ago New York, NY $200,000.00-$300,000.00 1 month ago United States $325,000.00-$350,000.00 1 day ago Vice President, Head of Global Medical Affairs
New York City Metropolitan Area $320,000.00-$360,000.00 5 days ago United States $90,000.00-$120,000.00 1 week ago Head Medical Excellence and New Products
United States $290,000.00-$315,000.00 1 day ago United States $130,000.00-$160,000.00 23 hours ago United States $300,000.00-$350,000.00 1 week ago United States $350,000.00-$425,000.00 3 weeks ago Los Angeles, CA $160,000.00-$175,000.00 1 month ago United States $170,000.00-$185,000.00 3 weeks ago Medical Director- Ambulatory Virtual Care
United States $222,000.00-$377,400.00 1 week ago Director, Physician Leadership Medical Directors + MD trainer
United States $298,000.00-$409,800.00 6 days ago United States $181,500.00-$272,300.00 56 minutes ago Director of Integrated Behavioral Health
Director Clinical Operations (medical device)
United States $190,000.00-$240,000.00 1 week ago United States $228,000.00-$244,000.00 1 day ago United States $200,000.00-$300,000.00 1 day ago Boston, MA $250,000.00-$315,000.00 3 weeks ago Were unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr