• Work closely with senior leaders in Medical, Operational Strategy, and Business Development to support client engagement • Support Business Development and Proposals teams by participating in the RFP process; prepare medical considerations section for proposals; and support or participate in bid defense meetings • Write or edit scientific content of deliverables within budget and timelines • Collaborate with Regulatory Affairs on regulatory product landscape and strategies as a part of overall drug development strategy • Provide scientific insight and create content for specified company releases (e.g., white papers and publication manuscripts) • Review and revise protocols, case report forms, training materials, project specific tools, analysis plans, study designs, clinical trial reports and new drug applications • Review laboratory values, adverse events, coded adverse event and medication data, and data tables, listings and figures as needed • Serve as a medical resource for study sites, the project team and clients • Assist in the preparation of the Medical Monitoring Plan and materials for investigator meetings and staff training sessions • Assume responsibility for medical and safety monitoring on assigned projects • Participate in feasibility discussions relating to specific project proposals • Develop training modules and provide training concentrating on disease states • Participate in process improvement activities • Collaborate with Senior Vice President, Global Medical and other members of the Medical Science Department to support growth and development activities globally • And other job duties as assigned by the line manager

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We’re looking for an experienced Medical Director (Utilization Management) to help lead clinical integrity and medical necessity decision-making across inpatient and post-acute care services for Medicare Advantage members. Reporting directly to the Chief Medical Officer, this physician leader will play a key role in ensuring appropriate, evidence-based, and compliant care decisions that support quality outcomes, cost efficiency, and regulatory excellence. - Conduct medical necessity reviews for inpatient admissions, continued stays, and post-acute care (SNF, IRF, LTACH, Home Health) - Apply MCG / InterQual guidelines and CMS criteria to utilization decisions - Serve as physician reviewer for complex and escalated UM cases - Participate in peer-to-peer discussions with attending physicians - Partner with UM and Care Management teams to ensure consistent, cost-effective care - Support CMS compliance, NCQA standards, audits, and delegated oversight - Identify utilization trends and contribute to quality improvement initiatives - Assist in developing medical policies and UM protocols - Maintain accurate clinical documentation per regulatory standards Qualifications - Deep expertise using MCG guidelines in clinical decision-making - Strong background in inpatient and post-acute utilization review - Experience working in managed care or health plan environments - Excellent analytical, documentation, and negotiation skills - Strong physician-to-physician communication abilities - Collaborative mindset and comfort working in matrix organizations - High attention to detail and commitment to confidentiality and compliance Requirements - MD or DO, licensed and in good standing - 5+ years of clinical experience, including 3+ years in UM or medical leadership - Strong knowledge of Medicare Advantage regulations & CMS coverage criteria - Experience with MCG or InterQual - Advanced computer skills (MS Office, medical management systems) Benefits - 100% Remote | Must work PST hours Preferred - MPH, MBA, or MHA - ABQAURP Certification

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Eastern Pennsylvania Physician Alliance (EPPA) is seeking a medical physician for psychiatric inpatient services at facilities located in central and western Pennsylvania. The schedule is PRN for medical H & Ps, consults, and follow-ups. This is a remote position. Qualifications - Board-certified family medicine or internal medicine - Active Pennsylvania medical license - Active DEA Requirements - Medical H & Ps, consults, and follow-ups for inpatient psychiatry patients - Collaborate with physicians, APPs, and support staff Benefits - Competitive compensation rate - Malpractice

• Independently deliver all medical support required for successful delivery of the projects • Actively listen and address client feedback and suggestions regarding medical study-related activities • Provide medical expertise in Proposal Development Teams