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Infotree Global Solutions

Utilization Medical Director

Infotree Global Solutions, New York, New York, United States

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We are seeking an experienced Physician Director to support clinical review and medical decision-making activities. This role involves reviewing complex clinical cases, analyzing medical records, and providing evidence-based determinations in alignment with established clinical standards, regulatory requirements, and organizational policies. The Medical Director will work collaboratively with healthcare providers and internal teams to promote consistent, high-quality clinical outcomes.

About the Role The ideal candidate demonstrates sound clinical judgment, professionalism, integrity, and the ability to function effectively in a structured, team-oriented environment.

Responsibilities Perform comprehensive and timely medical necessity and clinical appropriateness reviews Review and interpret medical records to evaluate quality and appropriateness of care Apply clinical guidelines, regulatory standards, and internal policies to decision-making Communicate clinical determinations clearly and professionally, both verbally and in writing Participate in clinical discussions with treating providers to obtain additional medical information when needed Maintain accountability for quality, productivity, and compliance standards Adapt to evolving workflows, tools, and clinical review practices Collaborate with multidisciplinary teams while exercising independent clinical judgment

Qualifications MD or DO degree Minimum 5 years of post-training direct clinical patient care experience Board Certification in an ABMS-recognized medical specialty Active, unrestricted medical license in at least one jurisdiction Experience in acute care, inpatient settings, and/or care of adult or aging populations Strong analytical, clinical reasoning, and communication skills Ability to meet credentialing and regulatory requirements

Required Skills Experience in clinical review, utilization management, or healthcare administration Familiarity with healthcare delivery systems, payer environments, or care management models Experience applying nationally recognized clinical guidelines Background in hospital-based or primary care specialties Ability to work effectively in a fast-paced, metrics-driven environment