Regional Medical Director – Nashville

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🔥 21 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $191.5k - $355.6k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Manage assigned aspects of medical policies and programs • Perform medical reviews • Interact with provider communities for assigned areas • Provide advanced clinical leadership across medical management programs • Integrate traditional utilization review with strategic population health, value-based care, and provider-performance initiatives • Align medical policy expertise with clinical strategy • Influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes

🎯 Requirements

• Physician with a current and unrestricted physician license in a state or territory of the United States • Maintain Board Certification as a M.D. or D.O. by an approved specialty board • 5 years of clinical experience • Analytical and communication skills • Strategic thinking skills • Ability to travel • 3 years Managed Care experience • IPA (independent Physician Association), MSO or Value Based Enablement Organization experience • Advanced skills in clinical interpretation, communication, data-driven strategy, and collaborative leadership • Experience with Stars performance, risk adjustment education, or provider engagement • Experience in matrixed environments and cross-functional clinical leadership • Remote work located in Nashville, TN • This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii

🏖️ Benefits

• Health and wellness benefits • 401(k) savings plan • Pension plan • Minimum of 15 days of paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan

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