Medical Director

At MTM, we are not just colleagues; we are collaborators on a shared mission; communities without barriers.

We have exciting opportunities to join our growing team where your work has a direct impact on the communities we serve.

Our company culture is one of innovation, collaboration, and growth.

If you are passionate, driven, and ready to join a team where your work will directly transform and shape our industry, then we want to talk to you!

What will your job look like?

The Medical Director will provide clinical oversight and guidance for the administration of Non-Emergency Medical Transportation (NEMT) services under the New Jersey Medicaid program.

The Medical Director will ensure compliance with state regulations, develop medical necessity guidelines, and serve as a liaison between healthcare providers, beneficiary organizations, and internal teams.

The ideal candidate will have strong Medicaid experience, expertise in utilization review, and a collaborative approach to improving access to care.

This position is contingent on award of contract.

What you’ll do:


* Ensure NEMT services meet medical necessity and coverage requirements under NJ Medicaid guidelines


* Review and approve medical policies related to transportation eligibility and utilization


* Develop and maintain coverage and medical necessity policies in alignment with state and federal regulations


* Collaborate with internal teams to implement best practices for claims processing and utilization review


* Act as a primary clinical liaison with physician groups, beneficiary organizations, and regulatory agencies


* Provide public relations support and represent the organization in meetings with healthcare providers and community partners


* Ensure adherence to NJ Medicaid coverage and payment rules


* Monitor and evaluate clinical processes for efficiency and compliance

What you’ll need:

Experience, Education & Certifications:


* Licensed physician (MD/DO), registered nurse (RN), or nurse practitioner (NP) in the State of New Jersey with an active, unrestricted license


* Relevant Medicaid experience within the health insurance industry


* Strong understanding of NJ Medicaid programs, coverage, and payment rules


* Minimum of 3 years of experience with a utilization review firm or health care claims processing organization


* Experience developing coverage or medical necessity policies and guidelines


* Public relations experience, particularly with physician groups and beneficiary organizations

Skills:


* Excellent communication and interpersonal skills


* Strong analytical and problem-solving abilities


* Ability to work collaboratively across clinical and operational teams


* Knowledge of healthcare compliance and regulatory requirements


* Experience handling sensitive and confidential information (HIPAA, PHI)

What’s in it for you:


* Health and Life Insurance Plans


* Dent...