Hiring: Medical Director, Utilization Management Company: Quantum Health Location: United States Job Posted Time: 2026-09-12 13:53:54 Employment Type: Hybrid Target Skills & Keywords : Clinical Documentation, Prior Authorization, Render, Utilization Review About the job Experience: •15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision. Required Skills: •This position is located at our Dublin, OH campus with hybrid flexibility. •Serves as a key clinical resource for staff. Establishes criteria and protocols for standard medical treatment inquiries and renders determinations on requests for healthcare services and/or treatment. •Conducts daily review of individual cases and has necessary case level conversations as requested. This includes prior authorizations and denial decisions for cases that do not meet established evidence-based criteria •Provides clear and concise documented medical review determinations and support on requested reviews within the established time frames •Provides clinical and nurse consultations •Identifies opportunities to implement best practices approaches and introduce innovations to provide improved outcomes •Performs utilization review and case management support on complex members •Provides support over the phone, through messaging and video to support chronic disease management Compensation: •Flexible work environment (work from home / hybrid options) Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!