Senior Director, Medical Policy & Payment Integrity

HCSC Group; Chicago (IL); Hybrid; USD 215,000 - 399,000; Full time

Benefits offered by this job

401(k) savings plan

pension plan

paid time off

paid parental leave

disability insurance

supplemental life insurance

employee assistance program

paid holidays

tuition reimbursement

Job summary

Health Care Service Corporation (HCSC) is seeking a physician leader to oversee medical policies and programs. You will perform medical reviews, interact with provider communities, and drive initiatives aligned with corporate strategy.

This hybrid role requires strong clinical background, board certification, and demonstrated capacity to manage complex projects and budgets while delivering results.

Qualifications

• Physician license in a U.S. state or territory (MD/DO).
• Board Certification by ABMS/NBPM or osteopathic board.
• 5 years of post-graduate patient care/clinical experience.
• 5 years of managed care experience with medical problems in managed care.

Responsibilities

• Perform medical reviews within assigned areas and interact with provider communities.
• Oversee medical policies and programs to align with corporate strategy.
• Translate needs into compelling business cases and justify investments.

Skills

Leadership skills

Strategic thinking

Communication skills

People management

Results orientation

Negotiation

Budget management

Business case development

Cost-benefit analysis

Office software

Education

MD/DO license

Board Certification

Tools

Microsoft Office

Lotus Notes

Job description

Health Care Service Corporation (HCSC) is seeking a physician leader to oversee medical policies and programs. You will perform medical reviews, interact with provider communities, and drive initiatives aligned with corporate strategy.

This hybrid role requires strong clinical background, board certification, and demonstrated capacity to manage complex projects and budgets while delivering results.