Medical Director, Utilization & Care Management

Highmark Inc. is seeking an experienced physician to join our utilization management team in a leadership capacity. You will review escalated cases, apply medical policy criteria, and determine medical necessity for treatments while maintaining regulatory compliance. Telephonic peer discussions may be required, with collaboration across CMDM and other specialties. The role requires MD/DO, active state licensure, and at least 5 years of direct patient care; board certification is expected. #J-18808-Ljbffr