Medical Director – Appeals

Health Care Service Corporation

. Handle assigned aspects of medical policies and programs .

Posted 10/9/2026full-timeRemote • United StatesLead💰 $191,500 - $355,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical policy management and clinical reviews, with a strong focus on strategic thinking and effective communication. Holds a valid physician license and board certification, complemented by extensive clinical and managed care experience.

Highest-signal resume keywords

Physician License (M.D. or D.O.)Board Certification5 Years Clinical ExperienceManaged Care ExperienceProficiency in Microsoft Office

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Medical ReviewElectronic DocumentationClinical ExperienceStrategic ThinkingAnalytical Skills

Soft Skills

Communication Skills

Tools & Technologies

Microsoft OfficeLotus Notes

Certifications & Qualifications

Board Certification by Specialty Board

Industry Keywords

Managed CareCardiologyGastroenterologyRheumatologyDermatologyHematologyOncologyInternal Medicine

About the role

Key responsibilities & impact

Handle assigned aspects of medical policies and programs
Perform medical reviews
Interact with provider communities for assigned areas
Conduct electronic documentation of case reviews

Requirements

What you’ll need

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 Microsoft Office and Lotus Notes, for electronic documentation of case reviews
3 years of Managed Care experience preferred
Cardiology, Gastroenterology, Rheumatology, Dermatology, Hematology, Oncology, or internal medicine specialty preferred but not required

Benefits

Comp & perks

Curated development plans fostering growth and rewarding careers
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
Annual incentive bonus plan subject to plan terms and conditions