Medical Director, Utilization & Care Management
Listed on 2026-09-30
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Doctor/Physician
Medical Doctor, Healthcare Consultant, Emergency Medicine Physician, Internal Medicine Physician
Highmark Inc. seeks a physician to join a utilization management team. You will review escalated cases against medical policy, determine medical necessity, and participate in care management as part of a multidisciplinary CMDM.
Telephonic peer-to-peer discussions may be required, with compliance to NCQA, URAC, CMS, DOH and DOL standards. Requirements include MD or DO, board certification, active state license, and 5 years of direct clinical experience. Travel 0-25%.
Our group is growing, and we are hiring a Medical Director, Utilization & Care Management in United States.
Consider building your career as a Medical Director, Utilization & Care Management at Highmark Health.
The Medical Director, Utilization & Care Management position in the Bio & Pharmacology & Health, Management & Operations field is open for applications.
We have an opening for a Medical Director, Utilization & Care Management in United States within Bio & Pharmacology & Health, Management & Operations.
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