Medical Director-Psychiatry

Curative HR LLC•Austin, TX

3d•$260,000 - $280,000•Remote

About The Position

Curative is seeking an enthusiastic, highly skilled, board-certified psychiatrist to serve as a Medical Director. This remote role oversees and performs utilization reviews and prior authorizations, makes medical necessity determinations, supports appropriate resource utilization and evidence-based care, and builds positive relationships with practitioners through peer-to-peer discussions. The role calls for a proactive, adaptable approach suited to a fast-paced, collaborative startup environment. No travel is required. The Medical Director reviews a wide range of healthcare services and makes clinical determinations using medical policies, evidence-based guidelines, regulatory requirements, and contractual agreements. The position also collaborates with internal clinical and operational teams, contributes to policy and process development, participates in quality activities, and maintains complete documentation of review work.

Requirements

Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited medical school.
Board certification in Psychiatry.
Active, unrestricted medical license in at least one state, with ability to obtain additional state licenses as needed.
At least 5 years of clinical practice experience.
At least 2–3 years of utilization management, medical review, or prior authorization experience within an insurance or managed care organization.
Demonstrated success conducting peer-to-peer discussions with external practitioners.
Excellent communication and interpersonal skills.
Strong understanding of medical necessity criteria, evidence-based medicine, and healthcare utilization management principles.
Strong analytical and critical-thinking skills, including the ability to synthesize complex clinical information and make sound medical decisions.
Exceptional written and verbal communication skills, including the ability to explain complex medical decisions clearly and empathetically.
Proficiency with electronic health records (EHR) systems and utilization management software.
Self-motivated and highly organized, with the ability to manage a high volume of cases in a remote work environment.
A proactive, hands-on attitude and enthusiasm for contributing to a rapidly growing startup.

Responsibilities

Perform prospective, concurrent, and retrospective medical necessity reviews for a wide range of healthcare services using clinical expertise, medical policies, and evidence-based guidelines.
Conduct prior authorization reviews in alignment with clinical criteria, regulatory requirements, and contractual agreements.
Lead peer-to-peer discussions with requesting practitioners, explain clinical rationales, encourage dialogue, and seek alternatives when appropriate.
Issue warranted medical necessity denials with documented rationales that comply with regulations and appeal processes.
Collaborate with Nurse Practitioners, Care Coordinators, and Operations to optimize utilization management processes and improve member outcomes.
Contribute to the development, review, and revision of medical policies, clinical guidelines, and utilization management protocols.
Participate in quality improvement initiatives, audits, and committee meetings as required.
Maintain detailed documentation of reviews, decisions, and peer-to-peer interactions.
Stay current on medical literature, healthcare trends, regulatory changes, and utilization management best practices.
Champion a member-centric approach while balancing clinical efficacy and cost-effectiveness.
Adapt to the evolving startup environment and take a proactive approach to problem-solving.

Benefits

Curative health plan with 100% employer-covered medical premiums for the employee and 50% coverage for dependents on the base plan.
$0 copays and $0 deductibles with completion of the Baseline Visit.
Preventive and primary care included in the health plan.
Mental health support.
One-on-one care navigation.
Chronic condition programs for diabetes, weight, and hypertension.
Maternity and family planning support.
24/7/365 Curative Telehealth.
Pharmacy benefits.
Comprehensive dental and vision coverage.
Employer-provided life and disability coverage, with supplemental options.
Flexible spending accounts.
Flexible work options, including remote and in-person opportunities.
Generous PTO policy and 11 paid annual company holidays.
401(k) for full-time employees.
Up to 8–12 weeks of paid parental leave, based on role eligibility.