Medical Director (Appeals)

HCSC • Richardson, TX

16d • Remote

About The Position

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 This Position Is Responsible For Assigned Aspects Of Medical Policies And Programs. Performs Medical Appeal Reviews And Interacts With The Provider Communities For Assigned Areas.

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
• Must reside withing 250 miles of the office or anywhere within the posted state.

Nice To Haves

• Board Certifification in Oncology, Physical Medicine and Rehabilitation , Surgical, Plastic Surgeon, or
• 3 years Managed Care experience

Responsibilities

• Assigned Aspects Of Medical Policies And Programs
• Performs Medical Appeal Reviews
• Interacts With The Provider Communities For Assigned Areas

Benefits

• 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
• other incentives

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: Ph.D. or professional degree
• Number of Employees: 5,001-10,000 employees