Medical Director

We’re building a world of health reputed company every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company : reputed company, a reputed company Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help reputed company health care. We reputed company that a reputed company care reputed company is more transparent and consumer-reputed company, and it recognizes physicians for their reputed company reputed company and effective use of health care resources. This is a remote reputed company (work from home) position. Ideal Candidates will reputed company in Midlands States (IL, MO, MN, WI) and have a medical license without encumbrances in one of these states. In the Medical Director role you will reputed company reputed company for medical policy implementation. You will participate in the development, implementation, and evaluation of reputed company / medical programs and expand reputed company's medical management programs to address member needs across the reputed company of care. You will support the Medical Management staff ensuring reputed company and consistent responses to members and providers. As a Medical Director you will reputed company primarily on overseeing utilization review and reputed company assurance while being responsible for predetermination reviews and review of claim determinations. This includes Prior Authorization / reputed company Certification / reputed company Reviews / Peer to Peer Calls / First Level Appeals / Special reputed company and Committee participation reputed company needed. The Medical Director will reputed company reputed company, coding, and reimbursement expertise as reputed company as directing case management reputed company necessary. In this role you will reputed company reputed company expertise and business direction in support of medical management programs through participation in reputed company team activities. The Medical Director will reputed company as reputed company business and reputed company reputed company to network providers and facilities to support the effective execution of medical services programs by the reputed company teams. Required Qualifications: Five (5) or more years of experience in Health Care Delivery reputed company e.g., reputed company reputed company and Health Care Industry. reputed company and reputed company medical license without encumbrances M.D. or D.O., reputed company and reputed company reputed company Certification in an ABMS or AOA recognized specialty including post-graduate reputed company reputed company care experience. Preferred Qualifications: Previous UM experience with a Health Plan / Payor/ Physician Advisor in a reputed company reputed company. reputed company Certification in Internal Medicine, Family Medicine, Emergency Medicine or Med / Peds / General Surgery Preferred. Education: Medical Doctor or Doctor of Osteopathic Medicine Pay reputed company The typical pay reputed company for this role is: $174,070.00 - $374,920.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in reputed company’s equity award program. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, reputed company on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 09/28/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job