
The Medical Director, Medical Management role at Highmark Inc. leads a physician team responsible for ensuring utilization management aligns with current clinical standards. Key duties include conducting electronic reviews of escalated cases to determine medical necessity, engaging in peer-to-peer discussions, and advising multidisciplinary teams on complex care scenarios. The position also involves developing clinical protocols and managing special projects to improve member care. This opportunity appeals to physicians seeking to impact population health within a collaborative environment that values critical thinking and professional growth. The role is primarily office-based with occasional travel up to 25 percent.














