Medical Director, Utilization & Care Management
Highmark Health
Highmark Health seeks a physician to perform utilization management reviews in alignment with clinical standards. You will review escalated cases, engage in peer-to-peer discussions when needed, and ensure compliance with NCQA, URAC, CMS, DOH, and DOL regulations. You will contribute to disease management as part of a multidisciplinary team, advise on high‑risk cases, and may lead special projects to improve member care. Travel up to 25% may be required. #J-18808-Ljbffr Highmark Health
Vacancy posted 2 days ago
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