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Highmark Health

Creating remarkable health experiences, freeing people to be their best.

Medical Director, Medical Management

Medical DirectorMedical DirectorFull TimeRemoteLeadTeam 10,001+Since 1852H1B SponsorCompany SiteLinkedIn

Location

Louisiana + 4 moreAll locations: Louisiana, North Carolina, Maryland, Pennsylvania, Washington

Posted

119 days ago

Salary

$170K - $352.5K / year

Seniority

Lead

Professional Certificate5 yrs expEnglish

Job Description

• Conduct electronic review of escalated cases against medical policy criteria • Complete initial determination of cases, review of appeals and grievances • Advise multidisciplinary team on cases that require physician expertise

Job Requirements

  • Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)
  • 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
  • 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

Benefits

  • Health insurance
  • Retirement plans
  • Paid time off

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