Job Title: Medical Director – Utilization Management

Location: Remote – Preference EST or nearby Pittsburgh PA,NY,WV

Duration: 6+ Months Contract Role with possible extension.

Client: Highmark Health

C2C Rate - $120-125/hr C2C

Must be a US Citizen





Position Overview

As part of a physician team, the Medical Director ensures utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of requested treatments or services. Depending on the nature of the case, telephonic peer-to-peer discussions may be required. The Medical Director ensures co...