Medical Director (Appeals)

About the role

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.

Responsibilities

• Responsible for assigned aspects of medical policies and programs.
• Performs medical reviews and interacts with the provider communities for assigned areas.

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 not required

Pay

Compensation: $191,500.00 - $355,600.00. Exact compensation may vary based on skills, experience, and location.

Schedule

This is a remote work from home role.