Medical Director, Medical Management
Highmark Health(3 months ago)
About this role
A physician role at Highmark responsible for performing utilization management reviews and ensuring treatment requests meet current clinical and regulatory standards. The physician reviews escalated cases using medical policy criteria, supports multidisciplinary case and disease management teams, and may contribute to protocol development and special projects.
Required Skills
- Critical Thinking
- Case Management
- Customer Service
- Communication
- Collaboration
- Listening
- Telephone Skills
- Clinical Software
- Computer Skills
- Managed Care
Qualifications
- Medical Doctor (MD)
- Doctor of Osteopathic Medicine (DO)
- Board Certification
- Active State Medical License
- Master's Degree (MBA or MPH) - Preferred
About Highmark Health
highmarkhealth.orgA national health and wellness organization as well as the second largest integrated delivery and financing system in America.
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