[Hiring] Regional Medical Director @Health Care Service Corporation

Role Description

This position is responsible for assigned aspects of medical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas. Provides advanced clinical leadership across medical management programs, integrating traditional utilization review with strategic population health, value-based care, and provider-performance initiatives. Aligns medical policy expertise with forward-leaning clinical strategy to influence quality, Stars-related performance, affordability, risk adjustment accuracy, and market-level outcomes.

Qualifications

• Physician with a current and unrestricted physician license in a state or territory of the United States.
• Maintain Board Certification as a M.D. or D.O. (by a specialty board approved by the American Board of Medical Specialties or the Advisory Board of Osteopathic Specialists).
• 5 years of clinical experience.
• Analytical and communication skills.
• Strategic thinking skills.

Requirements

• Ability to travel.
• 3 years Managed Care experience.
• IPA (Independent Physician Association) MSO or Value Based Enablement Organization Experience.
• Advanced skills in clinical interpretation, communication, data-driven strategy, and collaborative leadership.
• Experience with Stars performance, risk adjustment education, or provider engagement.
• Experience in matrixed environments and cross-functional clinical leadership.
• Remote work located in Nashville, TN.
• This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

Benefits

• Health and wellness benefits.
• 401(k) savings plan.
• Pension plan.
• A minimum of 15 days of paid time off.
• Paid parental leave.
• Disability insurance.
• Supplemental life insurance.
• Employee assistance program.
• Paid holidays.
• Tuition reimbursement.
• Other incentives.

Pay Transparency Statement

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and conditions of the plan.

Min to Max Range: $191,500.00 - $355,600.00. Exact compensation may vary based on skills, experience, and location.

EEO Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.