Medical Director – Physical Health

Alliance Health

Physical Health Medical Director providing oversight and expertise in clinical quality and utilization management. Ensures high-quality medical review processes while promoting operational support mainly in North Carolina.

Posted 7/15/2026full-timeCharlotte • North Carolina • 🇺🇸 United StatesLead💰 $211,172 - $269,245 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in utilization management and clinical oversight, with a strong focus on regulatory compliance, process improvement, and collaboration across medical and behavioral health teams. Holds an M.D./D.O. degree with board certification and extensive experience in managed care.

Highest-signal resume keywords

M.D./D.O. DegreeBoard CertificationUtilization Management ExperienceManaged Care PrinciplesClinical Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Case ReviewMedical Necessity CriteriaProcess ImprovementDiagnosis and Treatment TechniquesRegulatory Compliance

Soft Skills

CollaborationMentoringTraining

Tools & Technologies

Microsoft Office

Certifications & Qualifications

Active Medical License in North Carolina

Industry Keywords

Utilization Management GuidelinesClinical QualityInpatient and Outpatient CareEmerging Medical Trends

About the role

Key responsibilities & impact

Provide expert guidance and oversight for physical health service requests
Ensure the integrity and quality of utilization management activities
Participate in internal reviews of inpatient and outpatient clinical case types
Apply medical necessity criteria utilizing review criteria hierarchy
Complete expected case volume as expected by the department
Follow department processes as defined by approved Alliance policies
Support the Clinical Operations Department through active participation in organizational committees
Provide clinical guidance and leadership to promote collaboration between medical, behavioral, and care management teams
Maintain awareness of regulatory requirements, utilization management guidelines, and emerging trends
Contribute to process improvement initiatives aimed at enhancing clinical quality, efficiency, and member outcomes
Support cross functional teams with medical expertise
Train and mentor peers within the Medical Management team

Requirements

What you’ll need

Graduation from an accredited Medical School
M.D./D.O. degree is required and board certification in a relevant field
At least four (4) years of postgraduate clinical experience
Two (2) or more years of managed care and utilization management experience
Current, active, and unrestricted license to practice medicine in North Carolina or meets qualifications to obtain a North Carolina Medical License with Board certification for appropriate field of Medicine
Knowledge of the information and techniques needed for diagnosis and treatment of medical issues
Knowledge of Managed Care Principles
Knowledge of recent developments in the field of medicine
Microsoft Office Skills

Benefits

Comp & perks

Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility