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Medical Director Appeals (Government Appeals)

Health Care Service Corporation
United StatesRemotefull_timeVerifiedPosted 12 Feb 2024

About the role

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is  invested in your future!

Job Summary

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

This role is 100% fully remote

Must reside within one of our 5 state plans IL, TX, NM, OK, and MT

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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Company

Health Care Service Corporation

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