Medical Director, Physiatrist

Health Network One

. Provide clinical oversight and medical direction for musculoskeletal and therapy related programs and services .

Posted 4/21/2026full-timeRemote • Florida • 🇺🇸 United StatesLeadWebsite

About the role

Key responsibilities & impact

Provide clinical oversight and medical direction for musculoskeletal and therapy related programs and services
Ensure clinical policies, guidelines, and practices align with evidence based PM&R and MSK standards of care and applicable regulatory requirements
Serve as the senior clinical authority for MSK related questions, escalations, and complex case reviews
Perform and oversee utilization management reviews for MSK services, including physical therapy, occupational therapy, and related interventions
Conduct medical necessity determinations for prior authorization, concurrent, and retrospective reviews
Review and adjudicate clinical appeals and denials, including peer to peer discussions with ordering and rendering providers
Collaborate with operational and compliance teams to ensure utilization management activities meet contractual, regulatory, and accreditation standards
Act as a client facing clinical leader and PM&R specialist for Health Network One’s MSK service lines
Participate in client meetings, presentations, and consultations to explain MSK clinical programs, utilization management decisions, and outcomes
Support client relationships, retention, and growth by providing credible, data driven clinical guidance
Represent Health Network One with external stakeholders, including health plans, provider partners, therapy networks, and regulatory entities, as appropriate
Partner with the CEO and executive leadership team to support strategic planning, clinical program design, and growth initiatives for MSK services
Provide clinical insight to inform organizational decision making, risk management, and performance improvement efforts
Contribute to the development and refinement of clinical workflows, quality initiatives, and performance metrics aligned with organizational goals
Ensure compliance with federal and state regulations, accreditation standards, and client contractual requirements
Support quality management activities related to MSK services, including audits, reporting, and corrective action planning
Promote a culture of clinical excellence, accountability, and evidence based decision making

Requirements

What you’ll need

Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) with specialty training in Physical Medicine and Rehabilitation (PM&R)
7+ years of progressive accounting experience, including leadership responsibility
Active, unrestricted medical license in at least one U.S. state, with the ability to obtain additional licensure as needed
Board certified or board eligible in Physical Medicine and Rehabilitation
Demonstrated experience with utilization management, medical necessity review, appeals, and denials for MSK services
Strong executive level communication skills, including the ability to engage effectively with clients, providers, and senior leaders.
Preferred: Experience in managed care, health plans, MSOs, or delegated MSK or therapy services.
Prior experience in a physician executive or client facing clinical leadership role.
Familiarity with regulatory and accreditation standards related to utilization management and quality programs.

Benefits

Comp & perks

Equal Opportunity Employer

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

utilization managementmedical necessity reviewclinical oversightevidence based PM&RMSK standards of careclinical appeals and denialsperformance improvementquality managementclinical workflowsdata driven clinical guidance

Soft Skills

executive level communicationclient relationship managementleadershipcollaborationstrategic planningclinical insightaccountabilitypresentation skillsconsultationinterpersonal skills

Certifications

Doctor of Medicine (MD)Doctor of Osteopathic Medicine (DO)active medical licenseboard certified in Physical Medicine and Rehabilitation