Medical Director

Job not on LinkedIn

July 16

⚜️ Louisiana – Remote

Although this job is listed in Louisiana, this company may be open to hiring remote in other states.

🌲 North Carolina – Remote

Although this job is listed in North Carolina, this company may be open to hiring remote in other states.

+3 more states

⚜️ Louisiana – Remote 🌲 North Carolina – Remote 🦀 Maryland – Remote 🔔 Pennsylvania – Remote ☕ Washington – Remote

💵 $170k - $352.5k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

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Highmark Health

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Healthcare Insurance • Non-profit • Social Impact

Highmark Health is a healthcare company committed to reinventing the healthcare system and improving its services for everyone. The organization offers a broad range of career opportunities across various fields such as clinical care, technology, finance, and marketing. Highmark Health emphasizes diversity, equity, and inclusion in its workforce, creating a supportive environment for employees from all backgrounds. The company has been recognized for its commitment to disability inclusion, diversity, and military-friendly employment. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Health strives to create remarkable healthcare experiences for its customers and employees alike.

10,000+ employees

Founded 1852

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

💰 $5M Grant on 2021-05

📋 Description

• Ensure utilization management responsibilities are performed in accordance with the highest clinical standards. • Review escalated cases electronically and using Medical Policy criteria sets to evaluate treatment. • Participate as a physician member of the multidisciplinary team for case and disease management. • Advise on high-risk cases and help improve member care. • Compose clear rationales for member and provider notifications adhering to compliance standards.

🎯 Requirements

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) • 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) • 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry • Medical Doctor or Doctor of Osteopathic Medicine (DO) • Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards • Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.