Highmark Health
10,000+ employees
Founded 1852
⚕️ Healthcare Insurance
🤝 Non-profit
🌍 Social Impact
💰 $5M Grant on 2021-05
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.
Medical Director
Job not on LinkedIn
🕒 May 14
⚜️ Louisiana, North Carolina, +3 more states – Remote
💵 $227.6k - $385k / year
⏰ Full Time
🔴 Lead
👨⚕️ Medical Director
🦅 H1B Visa Sponsor
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Highmark Health
10,000+ employees
Founded 1852
⚕️ Healthcare Insurance
🤝 Non-profit
🌍 Social Impact
💰 $5M Grant on 2021-05
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.
📋 Description
• Ensure that utilization management responsibilities are performed in accordance with clinical standards. • Review escalated cases electronically and using Medical Policy criteria sets. • Conduct telephonic peer to peer discussions as required. • Ensure compliance to NCQA, URAC, CMS, DOH, and DOL regulations. • Participate as the physician member of the multidisciplinary team for case and disease management. • Advise multidisciplinary team on cases, particularly high-risk cases. • Manage projects and/or participate on project teams.
🎯 Requirements
• Required 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 preferred • Active medical state licensure required • Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards
🏖️ Benefits
• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options
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