
The Medical Director, Medical Management role at Highmark Inc. leads a physician team responsible for overseeing utilization management and ensuring clinical standards align with current regulations. Key duties include conducting electronic reviews of escalated cases to determine medical necessity, participating in multidisciplinary case management teams, and developing clinical protocols. The position offers the opportunity to influence care quality for members while working within a collaborative environment that values physician expertise. The role is primarily office-based with minimal travel requirements and supports professional growth through involvement in special projects and guideline development.




