Medical Director, Utilization & Care Management
Listed on 2026-10-11
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Doctor/Physician
Medical Doctor, Internal Medicine Physician, Chief Medical Officer / Medical Director, Healthcare Consultant
Highmark Health seeks a physician to ensure utilization management aligns with current clinical standards. You will review escalated cases electronically, engage in peer discussions, and advise the multidisciplinary team on high‑risk cases.
Compliance with NCQA, URAC, CMS, and related regulations is essential. You will participate in protocol development and lead projects to improve care for members, while maintaining strict documentation and communication standards.
As a Medical Director, Utilization & Care Management, you will play an important part at Highmark Health in Springfield, IL, United States.
For the Medical Director, Utilization & Care Management position at Highmark Health, we are reviewing applications now.
Step into the Medical Director, Utilization & Care Management role at Highmark Health in Springfield, IL, United States and grow with us.
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