Physician / Administration / Oklahoma / Permanent / Medical Director, Medical Management
Highmark Health
Not Specified, OK, USA
Not Specified, OK, USA
- Healthcare
- Full-time
- Medical Director
- Utilization Management
- Medical Management
The Medical Director leads physician teams to oversee utilization management, ensuring clinical standards are upheld in treatment evaluations. They review escalated electronic cases against medical policy criteria to determine the necessity and appropriateness of services. This role supports effective medical management within a healthcare organization.
Company : Highmark Inc. Job Description : JOB SUMMARY This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service.




