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✨ About The Role

- This position is a remote role primarily supporting the Aetna Better Health Plan of Illinois.
	- The Medical Director will oversee Utilization Management, including prior authorization and concurrent review processes.
	- Responsibilities include ensuring timely responses to members and providers regarding precertification and appeal requests.
	- The role involves managing cases related to inpatient and outpatient services, pharmacy, and state fair hearings.
	- The Medical Director will participate in a rotating on-call schedule for weekend and holiday coverage.
                            

⚡ Requirements

- The ideal candidate will have at least five years of experience providing direct patient care, demonstrating a strong clinical background.
	- A valid Illinois state medical license without encumbrances is essential for this role.
	- Candidates should possess an M.D. or D.O. degree along with current and active board certification in an ABMS or AOA recognized specialty.
	- Board certification in Neonatology, Neonatal-Perinatal Medicine, Pediatric Intensive Care, or General Pediatrics is preferred.
	- Experience in Utilization Management (UM) within a health plan or as a Physician Advisor is a significant advantage.
                            

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Medical Director - Medicaid (IL) - Remote Eligible

Remote

$174,070 - 374,920 USD / year

Healthcare Administration

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