Medical Director National OP, Medicare

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Medical Director National OP, Medicare based in the United States.

As a Medical Director, you will apply your clinical expertise and medical judgment to support evidence-based healthcare decisions and ensure appropriate utilization of medical services for Medicare populations.

You will evaluate complex clinical cases, review preauthorization requests, and determine whether requested treatments, levels of care, and service settings meet established clinical guidelines and regulatory requirements. Working remotely, you will collaborate with physicians, clinical teams, and healthcare leaders to promote quality, consistency, and responsible healthcare resource utilization.

You will also contribute to clinical reviews, appeals processes, and initiatives that support population health and value-based care. This role combines independent clinical decision-making with interdisciplinary collaboration in a structured, compliance-focused environment.

It offers an opportunity to extend your impact beyond direct patient care while helping improve healthcare quality, access, and outcomes for older adults and individuals with disabilities.