Remote Medical Director: Appeals & Policy Review

Health Care Service Corp.; Chicago (IL); On-site; USD 192,000 - 356,000; Full time

Benefits offered by this job

Health and wellness benefits

401(k) plan

Pension plan

Paid time off

Paid parental leave

Disability insurance

Life insurance

Employee assistance program

Paid holidays

Tuition reimbursement

Other incentives

Job summary

Health Care Service Corporation (HCSC) is seeking a physician to support our medical policies and programs. The role involves performing medical reviews and engaging with provider communities across assigned areas.

This is a remote, work-from-home opportunity designed for physicians with strong analytical and communication skills. The position emphasizes policy development and clinical judgment to translate medical information into practical guidelines, supporting the organization’s commitment

Qualifications

• MD/DO with current and unrestricted physician license in the United States.
• Maintain Board Certification by a specialty board approved by ABMS, NBPS, or 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.

Responsibilities

• Responsible for assigned aspects of medical policies and programs.
• Performs medical reviews and interacts with provider communities for assigned areas.

Skills

Analytical skills

Communication skills

Strategic thinking

MS Office proficiency

Education

MD/DO

Board Certification (ABMS/ NBPS/ Osteopathic boards)

Tools

Microsoft Office

Lotus Notes

Job description

Health Care Service Corporation (HCSC) is seeking a physician to support our medical policies and programs. The role involves performing medical reviews and engaging with provider communities across assigned areas.

This is a remote, work-from-home opportunity designed for physicians with strong analytical and communication skills. The position emphasizes policy development and clinical judgment to translate medical information into practical guidelines, supporting the organization’s commitment