Senior Medical Director
GE HealthCare
Part Time Medical Director – Behavioral Health
Capital Blue Cross
part-time
Posted on:
Location Type: Remote
Location: Remote • Pennsylvania • 🇺🇸 United States
Visit company websiteSalary
💰 $106,000 - $172,250 per year
Job Level
Lead
About the role
- Provides clinical leadership and oversight across Capital’s behavioral health operations, including Utilization Management (UM), Care Management (CM), and clinical rounds
- Conducts and oversees medical necessity reviews, benefit determinations, and appeals
- Collaborates with internal teams, external partners, and network providers to drive quality, improve member outcomes, and support organizational performance
- Analyzes data to identify trends and informs policy and program development
- Participates in accreditation and regulatory compliance, actively participating in committees and quality improvement activities
Requirements
- MD or DO Degree, as well as appropriate Board Certification
- Current unrestricted license in Pennsylvania as an MD or DO
- Currently covered by, or eligible to be covered by, medical liability insurance
- Current valid Pennsylvania drivers’ license
- A minimum of five years of clinical experience, post residency, including both inpatient and outpatient care
- A minimum of 8 years of experience in health care with an emphasis on analysis and process optimization
- Managed Care Organization and/or health insurance plan experience preferred
Benefits
- Medical, Dental & Vision coverage
- Retirement Plan
- Generous time off including Paid Time Off, Holidays, and Volunteer time off
- Incentive Plan
- Tuition Reimbursement
- Comprehensive benefits packaging
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
clinical leadershipUtilization ManagementCare Managementmedical necessity reviewsbenefit determinationsdata analysispolicy developmentprogram developmentaccreditationregulatory compliance
Soft skills
collaborationquality improvementorganizational performancetrend identification
Certifications
MD DegreeDO DegreeBoard Certificationunrestricted medical license
