Medical Director

Health Care Service Corporation•Nashville, TN

20d•$191,500 - $355,600

About The Position

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.

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

Nice To Haves

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.

Responsibilities

Identify opportunities to manage and improve underwriting tools, clinical reviews and processes.
Deploy new innovations.
Collaboratively engage clinical expertise across the Enterprise.
Leverage extensive clinical experience to enable delivery of HSB’s market-leading strategies.