Medical Director
Highmark Health(7 months ago)
About this role
The Physician Utilization Management role at Highmark Inc. involves working with a physician team to ensure utilization management responsibilities meet current clinical standards. This position reviews escalated cases using Medical Policy criteria to evaluate medical necessity for requested treatments, while also participating in multidisciplinary teams for case and disease management.
Required Skills
- Critical Thinking
- Case Management
- Customer Service
- Oral & Written Communication Skills
- Collaboration
- Clinical Software
- Managed Care
Qualifications
- Medical Doctor (MD)
- Doctor of Osteopathic Medicine (DO)
- Board Certification
- Active medical state licensure
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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