... Management or Public Health EXPERIENCE Required * 5 years in Clinical, Direct Patient care ... Medical Doctor or Doctor of Osteopathic Medicine (DO) * Awarded Board Certification at least once ...
... Management or Public Health EXPERIENCE Required * 5 years in Clinical, Direct Patient care ... Medical Doctor or Doctor of Osteopathic Medicine (DO) * Awarded Board Certification at least once ...
Sr. Med Dir, Med Mgmt
Boston, MA · On-site
$220K - $260K/yr
Overview The Senior Medical Director for Medical Management will lead medical management strategy and operations for the MassHealth Office of Clinical Affairs to ensure the delivery of medically ...
Sr. Med Dir, Med Mgmt
Boston, MA · On-site
$220K - $260K/yr
Overview The Senior Medical Director for Medical Management will lead medical management strategy and operations for the MassHealth Office of Clinical Affairs to ensure the delivery of medically ...
Senior Medical Director, Medical Management
$220K - $260K/yr
The Senior Medical Director for Medical Management will lead medical management strategy and operations for the MassHealth Office of Clinical Affairs to ensure the delivery of medically necessary ...
Senior Medical Director, Medical Management
$220K - $260K/yr
The Senior Medical Director for Medical Management will lead medical management strategy and operations for the MassHealth Office of Clinical Affairs to ensure the delivery of medically necessary ...
Medical Director (Medical Policy & Operations)
Hartford, CT · Remote
$174K - $374K/yr
In this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise and business direction in support of medical management programs to promote ...
Medical Director (Medical Policy & Operations)
Hartford, CT · Remote
$174K - $374K/yr
In this role as Medical Director MPO (Medical Policy & Operations) you will be responsible for providing clinical expertise and business direction in support of medical management programs to promote ...
Director Medical
Deerfield Beach, FL · On-site
The medical director provides physician direction and guidance to the hospice program, its ... Provide medical expertise on pain and symptom management to admission and patient care staff.
Director Medical
Deerfield Beach, FL · On-site
The medical director provides physician direction and guidance to the hospice program, its ... Provide medical expertise on pain and symptom management to admission and patient care staff.
Director, Medical Economics
New York, NY · Hybrid
$198K - $260K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
New York, NY · Hybrid
$198K - $260K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Tempe, AZ · On-site
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Tempe, AZ · On-site
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Medical Director/Medical Officer
RI · Remote
$130 - $135/hr
Medical Director (Remote - USA) 100% Remote | Must have an active, unrestricted state medical ... Provide clinical oversight and decision-making to support medical management programs. * Oversee ...
Quick apply
Medical Director/Medical Officer
RI · Remote
$130 - $135/hr
Medical Director (Remote - USA) 100% Remote | Must have an active, unrestricted state medical ... Provide clinical oversight and decision-making to support medical management programs. * Oversee ...
Director, Medical Economics
New York, NY · Hybrid
$198K - $260K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Quick apply
Director, Medical Economics
New York, NY · Hybrid
$198K - $260K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Dallas, TX · On-site
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Dallas, TX · On-site
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Atlanta, GA · Remote
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Quick apply
Director, Medical Economics
Atlanta, GA · Remote
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Tempe, AZ · Hybrid
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Tempe, AZ · Hybrid
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Dallas, TX · Remote
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Dallas, TX · Remote
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Director, Medical Economics
Tempe, AZ · Hybrid
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Quick apply
Director, Medical Economics
Tempe, AZ · Hybrid
$178K - $234K/yr
We're hiring a Director, Medical Economics to join our Actuarial team. Oscar is the first health ... You will manage your team to contribute analyses, reports, and dashboards to the medical economics ...
Utilization Management - Medical Director
$200K - $225K/yr
... Medical Director of Utilization Management to provide clinical leadership within a growing health plan environment serving Medicare and Medicaid populations. This is an outstanding opportunity for a ...
Utilization Management - Medical Director
$200K - $225K/yr
... Medical Director of Utilization Management to provide clinical leadership within a growing health plan environment serving Medicare and Medicaid populations. This is an outstanding opportunity for a ...
Utilization Management - Medical Director
New York, NY · On-site
$200K - $225K/yr
... Medical Director of Utilization Management to provide clinical leadership within a growing health plan environment serving Medicare and Medicaid populations. This is an outstanding opportunity for a ...
Utilization Management - Medical Director
New York, NY · On-site
$200K - $225K/yr
... Medical Director of Utilization Management to provide clinical leadership within a growing health plan environment serving Medicare and Medicaid populations. This is an outstanding opportunity for a ...
Medical Director of Utilization Management
Manhattan, NY · Remote
$201K - $227K/yr
Medical Director of Utilization Management Location: 120 Broadway New York (Must Reside in NY/NJ/CT) Work Schedule: Full-Time Compensation: $201,807.75 - $227,033.72 Annual Salary A little about us ...
Quick apply
Medical Director of Utilization Management
Manhattan, NY · Remote
$201K - $227K/yr
Medical Director of Utilization Management Location: 120 Broadway New York (Must Reside in NY/NJ/CT) Work Schedule: Full-Time Compensation: $201,807.75 - $227,033.72 Annual Salary A little about us ...
The Medical Director is responsible for conducting day-to-day medical management and leading ongoing improvement initiatives in collaboration with the Director of Operations, Quality Improvement ...
The Medical Director is responsible for conducting day-to-day medical management and leading ongoing improvement initiatives in collaboration with the Director of Operations, Quality Improvement ...
Director, Medical Policy
Canton, MA · On-site
Effective stakeholder management is a critical function of a director. Key Responsibilities/Duties - what you will be doing (top five): * Medical Policy * Responsible for all initiatives, project ...
Director, Medical Policy
Canton, MA · On-site
Effective stakeholder management is a critical function of a director. Key Responsibilities/Duties - what you will be doing (top five): * Medical Policy * Responsible for all initiatives, project ...
Director, Medical Writing
Princeton, NJ · On-site
$198K - $297K/yr
Role The Director, Medical Writing is responsible for advancing the medical writing portfolio ... This role collaborates with the other members of the Medical Writing Leadership Team to manage the ...
Director, Medical Writing
Princeton, NJ · On-site
$198K - $297K/yr
Role The Director, Medical Writing is responsible for advancing the medical writing portfolio ... This role collaborates with the other members of the Medical Writing Leadership Team to manage the ...
Director Medical Management information
See salary details
$13K - $44.3K
2% of jobs
$44.3K - $75.5K
1% of jobs
$75.5K - $106.8K
5% of jobs
$106.8K - $138.1K
3% of jobs
$138.1K - $169.4K
5% of jobs
$197.7K is the 25th percentile. Wages below this are outliers.
$169.4K - $200.6K
9% of jobs
$200.6K - $231.9K
19% of jobs
The median wage is $238.9K / yr.
$231.9K - $263.2K
22% of jobs
$278.3K is the 75th percentile. Wages above this are outliers.
$263.2K - $294.5K
17% of jobs
$294.5K - $325.7K
10% of jobs
$325.7K - $357K
6% of jobs
$13K
$232.4K
$357K
How much do director medical management jobs pay per year?
What does a medical director do?
Is a medical director a high position?
What is the highest paying job in healthcare management?
What is the difference between Director Medical Management vs Medical Case Manager?
| Aspect | Director Medical Management | Medical Case Manager |
|---|---|---|
| Credentials | Typically requires a healthcare-related degree and management experience | Licensed healthcare professionals, often registered nurses or social workers |
| Work Environment | Senior leadership in healthcare organizations, overseeing teams and policies | Direct patient interaction, assessing and coordinating care |
| Employer & Industry | Hospitals, insurance companies, healthcare systems | Insurance companies, healthcare providers, community agencies |
The main difference is that the Director Medical Management focuses on overseeing medical management programs and teams at an organizational level, while the Medical Case Manager directly manages individual patient cases, coordinating care and services. Both roles require healthcare knowledge, but the director role emphasizes leadership and strategy, whereas the case manager role emphasizes patient care coordination.
How much does a medical director make in the US?

$385K/yr
Full-time
Re-posted 29 days ago
Highmark Health rating
7.8
Based on 28 frontline employees who took The Breakroom Quiz
Job description
JOB SUMMARY
This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members
ESSENTIAL RESPONSIBILITIES
- Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care.
- Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise.
- Participate in protocol and guidelines development to ensure consistency in the review process.
- Actively manage projects and/or participate on project teams that require a physician subject matter expert.
- Other duties as assigned.
EDUCATION
Required
- Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)
Substitutions
- None
Preferred
- Master's Degree in Business Administration/Management or Public Health
EXPERIENCE
Required
- 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
Preferred
- 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry
LICENSES AND CERTIFICATION
Required
- Medical Doctor or Doctor of Osteopathic Medicine (DO)
- Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards
- Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.
Preferred
- None
SKILLS
- Critical Thinking
- Case Management
- Customer Service
- Oral & Written Communication Skills
- Collaboration
- Listening
- Telephone Skills
- General Computer Skills
- Clinical Software
- Managed Care
Language (Other than English)
None
Travel Required
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$227,600.00Pay Range Maximum:
$385,000.00Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
What Highmark Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Highmark Health
Sourced by ZipRecruiter
A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia, and eastern and northwestern New York with customers in 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. And our companies cover a diversified spectrum of essential health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions. Our financial position reflects strength and stability, with our year-end 2022 consolidated revenues totaling $26 billion. And we're proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
Industry
Health care and social assistance and insurance services
Company size
10,000+ Employees
Headquarters location
Pittsburgh, PA, US