Health Plan Medical Director (Utilization Management) Recruiters
Healthcare Headhunters recruits healthcare professionals for employers. No upfront fee. You pay only if you hire.
This is what we do all day: recruit healthcare professionals.
Hire a physician leader who can make defensible coverage decisions and handle difficult physician-to-physician reviews.
No postings. No stacks of resumes. No chasing. You interview a short list.
No upfront fee. You pay only if you hire.
Need someone now? Call 305-306-4829.
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What happens next
- We review your role, responsibilities and location.
- Ivan or a senior team member will reach out soon.
- You meet a focused shortlist when qualified candidates fit the agreed search.
- Fees.
- No upfront fee. Pay only if you hire, under the signed agreement.
- Exclusivity.
- Set out in the signed client agreement.
- Confidentiality.
- We agree the brief before outreach. This is not a promise of absolute anonymity.
- No hire.
- No hire means no fee on standard searches.
- UM Medical Director
- Medicare Advantage Medical Director
What does an open seat cost you every week?
An open role costs you more than the recruiting fee. Someone covers the work, waits for care, or stops a service. We ask what is falling behind and who is carrying it. Use your own figures to compare the cost of waiting with the cost of hiring.
The seat is costing you every week.
Overtime, diverted patients, a stretched team and a schedule held together by favors.
The posting brought the wrong people.
Applicants arrive, but the person who has done this exact work is employed and not looking.
You are the one chasing.
Screening calls, no-shows and follow-ups land on the desk of someone with a facility to run.
What does this hire really come down to?
A health plan medical director must read the chart, apply plan criteria, document the rationale, and speak directly with treating physicians. We recruit physicians who can make those calls without treating a coverage review like a bedside consultation. Your team may need faster decisions on standard admissions, stronger review notes, or a physician who will take disputed cases.
We clarify which work is sitting with this hire before presenting candidates.
The right physician does more than know a specialty. They can separate a covered service question from a disagreement about a treatment plan. During a peer-to-peer discussion, they should explain the relevant record, the criteria, and what information could change the decision.
What do we check before you see anyone?
Active, unrestricted license: We confirm an active, unrestricted license in the state where your role calls for one. We ask candidates how they track renewal dates and whether any past license action needs employer review. Board certification: We verify current board certification and the clinical specialty behind it.
- We ask how that specialty experience helps the physician speak credibly with attending physicians outside their usual practice area.
- InterQual or MCG application: We ask for a de-identified example of applying InterQual or MCG when the record did not fit neatly into a single pathway. The useful answer identifies the facts reviewed, the criterion used, and the reasoning recorded.
- Peer-to-peer reviews: We ask candidates to walk through a disputed coverage decision with a hypothetical treating physician. We listen for a clear explanation, willingness to hear new facts, and a firm boundary when the record still does not support approval.
- NCQA standards: We ask what review notes, decision letters, audit trails, and escalation records the candidate has worked with under NCQA standards. Your team can then judge whether that experience matches its documentation process.
- Work history and fit: We screen for the actual rhythm of the job, including scheduled review blocks, case escalation, medical policy discussions, and collaboration with nonclinical staff. You complete your own credentialing and clinical assessment before hiring.
Where do we find them, and why would they move?
Physician advisors are a strong source pool because they have reviewed charts from the provider side and discussed coverage criteria with plans. Some move when they want their administrative work to become their primary role rather than an added hospital duty.
We also speak with practicing physicians considering nonclinical work and physicians at other payers. A move may follow reduced procedural work, a desire for more predictable hours, a change in leadership, or interest in a broader policy role. We test the reason for moving rather than assume it.
Which mistakes stall the search?
A common mistake is hiring a respected clinician who has never explained a coverage denial can leave difficult peer discussions unresolved or poorly documented. Another is treating InterQual or MCG familiarity as a keyword can miss physicians who cannot explain how the record supported the selected pathway.
Interviewing only physicians can overlook whether the candidate can explain a decision to nurses, operations staff, appeals teams, and provider offices.
How would we run the search for this opening?
Interview your clinical and operational leaders together. A director handling escalated cases needs comfort discussing incomplete records, exceptions, appeal risk, and conflicting clinical opinions. Ask where the role spends time. A director handling routine inpatient authorization reviews needs disciplined, repeatable judgment.
Set the review scope
Tell us which decisions belong to this physician, which cases escalate to them, and whether the work centers on admissions, services, appeals, or medical policy questions.
Test a realistic case
Give finalists a hypothetical chart summary and ask what additional facts they would request, which criteria they would consult, and how they would document the decision.
Compare the final slate
Compare how each physician handles disagreement, explains the record, and fits your approval and escalation process.
Where this search connects
Physician Executives & Medical Directors
SpecialtyHospitals & Health Systems
SettingAcademic Medical Centers
SettingChildren's Hospitals
SettingRural & Critical Access Hospitals
SettingHealth Plan Medical Director, Medicare Advantage
Role in a settingChief Medical Officer (CMO)
Related roleVice President of Medical Affairs (VPMA)
Related roleMedical Director (Practice, Clinic, Region)
Related roleHospice Medical Director
Related roleNational median annual wage. SOC 11-9111, Medical and Health Services Managers.
BLS publishes Medical and Health Services Managers as a wider occupation. This administrative or professional function proxy does not isolate Health Plan Medical Director (Utilization Management), its clinical credentials, seniority or setting. It is not a pay estimate for the exact title.
Source: U.S. Bureau of Labor Statistics, OEWS, 2025-05, released 2026-05-15. View source. See the full guide.
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How do we test peer-to-peer skill before an offer?
Use a hypothetical denial or adverse decision discussion based on a short chart summary. Ask the candidate to explain the decision, invite relevant new information, and state what would change the outcome. Your interviewers can assess clinical judgment and communication directly.
Should we hire a physician advisor or a payer-side medical director?
A physician advisor may bring strong hospital review experience and provider perspective. A payer-side candidate may bring direct exposure to coverage decisions, documentation routines, and peer-to-peer work. We screen both groups against the work your opening actually assigns.
Is InterQual or MCG experience enough by itself?
No: ask how the physician handled a record that did not match the obvious pathway or lacked key documentation. A strong candidate can describe the questions asked, the source used, the rationale, and the note left for later review.
What is the fee structure for a permanent search?
No upfront fee. You pay only if you hire. We offer a candidate replacement guarantee on standard search agreements. The applicable period and exact terms are set out in the signed client recruiting agreement.
Can we also request temporary physician coverage?
We arrange locum tenens, travel and contract coverage on request. Credentialing, licensing and malpractice coverage are confirmed per engagement before anyone starts. Per diem placement means adding a physician to your own pool, not covering individual shifts.
What should you send us about this role?
Send us the role, where the person will work and what needs to change with this hire. We will ask about the work, not just the title. Share any license or schedule limits that could rule someone out before we begin the search.
Tell us where decisions stall, what the physician will review, and who joins the final interview. We will begin a permanent contingency search with no upfront fee.
No upfront fee. You pay only if you hire. We offer a candidate replacement guarantee on standard search agreements. The applicable period and exact terms are set out in the signed client recruiting agreement.
What happens next
- We review your role, responsibilities and location.
- Ivan or a senior team member will reach out soon.
- You meet a focused shortlist when qualified candidates fit the agreed search.
- Fees.
- No upfront fee. Pay only if you hire, under the signed agreement.
- Exclusivity.
- Set out in the signed client agreement.
- Confidentiality.
- We agree the brief before outreach. This is not a promise of absolute anonymity.
- No hire.
- No hire means no fee on standard searches.
Which other positions in this family should you consider?
SNF / Post-Acute Medical Director · Physician Advisor (Utilization Review)
What do you get at each step of the search?
Our process for every search: calibrate the seat with you, map the market, research the real people, reach out to each one personally, qualify them in live conversation, then hand you a short list with a written brief on each person and support through the offer.
Search Calibration
You get an agreed brief: the work, reporting line, credentials, schedule, and offer you can make.
Market Mapping
You get a search aimed at relevant backgrounds, including people working now who have not applied.
Professional Contact Intelligence
We check appropriate ways to reach the people identified for your search. You do not have to chase them yourself.
Persistent Personalized Outreach
We explain your actual job and follow up with people who may consider a conversation.
Live Candidate Qualification
You see people we have spoken with about the work, interest, and practical fit, not an unread resume pile.
Candidate Intelligence and Process Support
You get a written brief and support through interviews and offer discussions. You make the hiring decision.
How long will it take to see a short list?
That depends on the job, schedule, available people, and what your employer can offer. We discuss those constraints before outreach and update you as candidates respond. We do not promise a fixed shortlist date. We check the job brief before arranging interviews. Tell us which parts of the role you can change.
What if a candidate receives a counteroffer?
We ask why the person wants to move and discuss competing decisions before an offer. A counteroffer can still change their choice. Keep the duties and offer clear rather than assuming more money settles every concern. Tell us early if parts of your offer cannot change, so the candidate hears it from us first.
What are the replacement terms?
We offer a candidate replacement guarantee on standard search agreements. The applicable period and exact terms are set out in the signed client recruiting agreement. Ask us to walk through those terms before you sign, so you know how a replacement would work for your opening and who would start it.
What do we not do in a standard permanent search?
We do not bill standard contingency search by the hour or simply repost your job. Temporary coverage is a separate arrangement. Any retainer or different engagement must be agreed, not assumed. Tell us early if you need coverage while the permanent search runs.