Physician - Medical Director, Utilization Management Opportunity in Pinehurst, NC We are seeking an experienced physician leader to serve as Medical Director of Utilization Management in Pinehurst, North Carolina. This role offers a unique opportunity to influence healthcare delivery, optimize resource use, and improve patient outcomes within a large, community-based health system. Position Highlights: Full-time, on-site leadership position Monday-Friday, 8 AM-5 PM schedule Competitive guaranteed base salary with comprehensive benefits package Health, life, disability insurance Paid malpractice with tail coverage Retirement savings plans (401a, 403b with match, 457b) Paid time off, CME allowance, license and DEA reimbursement Free fitness center membership, wellbeing resources, and paid parental leave Responsibilities: Serve as the clinical expert on physician practice patterns, medical necessity, and appropriate utilization of resources Monitor over- and under-utilization, care progression, denial management, and compliance with payer and governmental requirements Collaborate with hospital and medical staff leadership to develop and implement evidence-based care management protocols Ensure proper documentation, coding, and resource utilization across departments Support interdisciplinary collaboration with medical staff, ancillary departments, and administration Participate in quality improvement initiatives and organizational performance excellence efforts Qualifications: MD or DO degree with active, unrestricted North Carolina medical license Current ABMS or AOA board certification CHCQM-PHYADV certification (or ability to obtain within 90 days of employment) Minimum 5 years of post-residency clinical practice experience, including at least 1 year in utilization management Strong leadership skills with ability to collaborate effectively across disciplines In-depth knowledge of CMS and compliance requirements, hospital coding/billing, payer contracting, and revenue cycle management Proficiency in EMRs and utilization review tools Community Highlights: Pinehurst is renowned for its Southern charm, world-class golf courses, and outdoor recreation opportunities Located just 1 hour from Raleigh-Durham, 2 hours from Charlotte, and 3 hours from both the beach and mountains Four-season climate with exceptional quality of life Strong local economy supported by healthcare, education, tourism, and small business Consistently ranked among North Carolina's safest and most desirable communities This leadership role provides the opportunity to combine clinical expertise with organizational strategy, driving measurable improvements in care quality and resource utilization while enjoying a high quality of life in Pinehurst, NC.
