Associate Medical Director – UM

Independent Health

. Assist the Medical Director in overseeing Utilization Management (UM) programs .

Posted 9/16/2026full-timeBuffalo • New York • United StatesLead💰 $250,000 - $300,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Utilization Management (UM) programs, clinical oversight, and compliance with medical necessity requirements. Proven ability to analyze healthcare data and collaborate effectively with multidisciplinary teams to improve clinical service operations.

Highest-signal resume keywords

Utilization Management (UM)Clinical OversightHealthcare Data AnalysisBoard Certification in Primary CarePost-Graduate Clinical Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Program DevelopmentQuality AssurancePeer ReviewMedical Necessity DeterminationPerformance ReportingStrategic Direction DevelopmentHEDIS InitiativesPrior AuthorizationStep TherapyQuantity Limit Programs

Soft Skills

Excellent Verbal CommunicationExcellent Written CommunicationInterpersonal SkillsTeam CollaborationAccountability

Tools & Technologies

Clinical Service OperationsHealthcare Management Software

Certifications & Qualifications

Graduate Degree from Accredited Medical SchoolUnrestricted Medical License in NYBoard Certification by ABMS

Industry Keywords

Utilization ReviewHealthcare ManagementClinical Quality CommitteesRegulatory ComplianceMedical Community Standards

About the role

Key responsibilities & impact

Assist the Medical Director in overseeing Utilization Management (UM) programs
Support the development and maintenance of UM programs, focusing on clinical accuracy and appropriateness
Assist in developing strategic corporate direction and focus for UM programs
Support the SVP, Healthcare Services in preparing annual UM program metrics
Contribute to measurable outcomes for prior authorization, step therapy, and quantity limit programs
Collaborate with internal teams on corporate HEDIS initiatives and clinical program development
Provide clinical guidance and oversight to clinical program development teams, clinical service operations, and clinical quality committees
Serve on Independent Health committees as directed by the Medical Director
Ensure UM decisions comply with member contracts, medical necessity requirements, approved policies, and regulatory requirements
Ensure appropriate information is available to determine medical necessity
Ensure reviews are completed within regulatory time frames
Work with UM leadership to ensure process accuracy, consistency, and efficiency
Assist UM leadership with performance reporting
Support improvements to clinical service operations

Requirements

What you’ll need

Graduate Degree required from an accredited medical school and residency program required
Master’s degree in healthcare administration, business, or public health preferred
Unrestricted, current, active license to practice medicine issued by the NY State Board of Licensure or the State Board of Osteopathic Examiners
Member in good standing in the medical community
Board certified in a recognized medical specialty recognized by the American Board of Medical Specialists (ABMS); Primary Care preferred
Five (5) years of post-graduate clinical experience in health care management and utilization review required
Quality assurance and peer review experience preferred
Private practice experience preferred
Ability to rotate in UM call schedule to remotely cover evenings, weekends and holidays
Excellent verbal, written and interpersonal communication skills required
Solid computer navigational skills required
Demonstrated ability to work effectively as a member of a multi-disciplinary team
Demonstrated ability to analyze, interpret and communicate significance of health care data
Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, and Accountable
Immigration or work visa sponsorship will not be provided for this position

Benefits

Comp & perks

Scorecard incentive eligibility
Full range of benefits
Generous paid time off