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Health Care Service Corporation

Medical Director (Appeals)

chicago, IL

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Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas.

Job Requirements

Physician (M.D. or D.O) with a current and unrestricted physician license in a state or territory of the United States

Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists

5 years of clinical experience

Analytical and communication skills

Strategic thinking skills

Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews

Preferred Requirements

3 years Managed Care experience

Cardiology, Gastroenterology, Rheumatology, Dermatology, Hematology, Oncology and internal medicine specialties preferred but nt required

This is a remote work from home role

Compensation: $191,500.00 - $355,600.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

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Worksite address

chicago, IL, 60290, US

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.

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