Role overview

Qualifications

Physician (M.D. or D.O) with unrestricted license
Maintain Board Certification by a specialty board
5 years of clinical experience
Analytical and communication skills

Responsibilities

Work closely with HSB’s National Medical Director and leadership
Identify opportunities to manage and improve underwriting tools
Deploy new innovations and engage clinical expertise
Enable delivery of HSB’s market-leading strategies

Key facts

Remote from: Anywhere
Full time
Expert & Leadership (>10 years)
Medical Administrator
English

Hard skills

Medical Licensing (Health Law) IBM Notes Medical Practice Experience Medigap Social Security Disability Insurance Fraud Investigation

Other skills

Analytical Skills
Verbal Communication Skills
Strategic Thinking
Microsoft Office

About the company

Health Care Service Corporation

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, 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, gender, national origin, disability, or protected veteran status.

Company details

Company typeXLarge

Company size10001

Links

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Job description

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.

Job Summary

The HealthSpring Supplemental Benefits (HSB) Medical Director will work closely with HSB’s National Medical Director and HSB leadership to identify opportunities to manage and improve underwriting tools, clinical reviews and processes, deploy new innovations, and collaboratively engage clinical expertise across the Enterprise.The ideal candidate will leverage their extensive clinical experience to enable delivery of HSB’s market-leading strategies, improving the lives of the individuals we serve.

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:

10 years clinical practice experience preferred
Experience in Medigap, Supplemental Health Insurance, or Medical Underwriting is preferred, but not required.
MBA or equivalent experience preferred.
Experience with case management preferred and familiarity with fraud, waste, and abuse reviews a plus.

INAK

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

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$191,500.00 - $355,600.00

Exact compensation may vary based on skills, experience, and location.