Part-Time Medical Director, Arbitrations & UM (Hybrid)

Blue Shield of California; Long Beach (CA); Hybrid; USD 120,000 - 180,000; Part time

Job summary

Blue Shield of California seeks a part-time Medical Director, Arbitrations and UM MD Float to provide clinical review for provider arbitrations across Commercial and Medicare lines.

Reporting to the Sr. Medical Director, this role offers hybrid virtual work with periodic in-office presence, and requires California licensure and ABMS board certification. Strong leadership and communication skills are essential.

Qualifications

• Medical degree (M.D. or D.O.) required.
• Residency completed in an adult-based primary care specialty or related field.
• Active, unrestricted California medical license required.
• Board certification in an ABMS-recognized specialty required (Internal Medicine preferred).
• Minimum of 5 years of direct patient care experience after residency.
• Familiar with utilization management, Medicare, NCQA/URAC or quality programs.

Responsibilities

• Provide clinical review and support for provider arbitrations across Commercial and Medicare lines of business.
• Deliver flexible UM Medical Director coverage based on operational needs.
• Translate detailed analyses and complex materials into compelling communications for stakeholders.
• Collaborate with cross-functional teams to drive evidence-based decision making.

Skills

Leadership

Communication

Analytical

Time management

Organization

Collaboration

MS Excel

Public speaking

Education

MD or DO

Residency in adult-based primary care or related specialty

California medical license

ABMS board certification (Internal Medicine preferred)

Tools

Microsoft Excel

Outlook

Word

PowerPoint

Job description

Blue Shield of California seeks a part-time Medical Director, Arbitrations and UM MD Float to provide clinical review for provider arbitrations across Commercial and Medicare lines.

Reporting to the Sr. Medical Director, this role offers hybrid virtual work with periodic in-office presence, and requires California licensure and ABMS board certification. Strong leadership and communication skills are essential.