Medical Director
Job Description
Assist the Chief Medical Director in directing and coordinating medical management, quality improvement, and credentialing functions for the Medicare business unit. This role involves working closely with the Population Health and Clinical Operations Partners, specializing in concurrent review, post-acute care reviews, pre-service, and appeals related to inpatient and post-acute care stays.
Responsibilities
Collaborate with the Chief Medical Director to manage the Medicare line of business.
Handle a high volume of inpatient and post-acute care cases.
Facilitate discharge planning and transitions to appropriate care levels.
Provide resources to help avoid readmissions and support transitions home with necessary DME/services.
Work collaboratively with a dedicated and supportive team.
Essential Skills
Experience in Medicare, utilization management, and concurrent review.
Board certification through American Board Medical Specialties.
Current state medical license without restrictions.
Active board certification in Internal Medicine or Family Medicine.
Experience with InterQual or MCG clinical guidelines for utilization management.
Additional Skills & Qualifications
Licensure in Florida and Texas required; preference for additional licensure in MI, MS, NJ, NC, CA, KS, and AR.
Experience with appeals for inpatient care is a plus.
Work Environment
Typically work from 8 AM to 5 PM in the local time zone, with occasional extended hours if needed. The team operates on three different platforms to complete tasks, with frequent interactions via teams to provide support and assistance. The work environment is collaborative, with a strong team ethos and willingness to help one another.
Job Type & Location
This is a Contract to Hire position based out of St. Louis, Missouri.
Pay and Benefits
The pay range for this position is $120.00 - $134.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Sep 19, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.