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Director Medical Management Jobs in Michigan (NOW HIRING)

County of St. Clair

Deputy Medical Director

Port Huron, MI · On-site

$88K - $115K/yr

... and management of other diseases of public health significance, including tuberculosis The Deputy will also represent the Medical Director at on-site and other local meetings, particularly of a ...

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Director Medical Management information

What is the difference between Director Medical Management vs Medical Case Manager?

AspectDirector Medical ManagementMedical Case Manager
CredentialsTypically requires a healthcare-related degree and management experienceLicensed healthcare professionals, often registered nurses or social workers
Work EnvironmentSenior leadership in healthcare organizations, overseeing teams and policiesDirect patient interaction, assessing and coordinating care
Employer & IndustryHospitals, insurance companies, healthcare systemsInsurance 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.

What cities in Michigan are hiring for Director Medical Management jobs?

Cities in Michigan with the most Director Medical Management job openings:

Director Medical Management jobs near you
Infographic showing various Director Medical Management job openings in Michigan as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Medical Director Medical Policy

Blue Cross Blue Shield of Michigan

Detroit, MI

Full-time

Posted 9 days ago

Blue Cross Blue Shield of Michigan rating

7.8

Company rating: 7.8 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

197th of 315 rated insurance

Job description

Provides clinical program leadership and develops, implements and approves policies within recognized area of responsibility.

  • Develop and maintain medical policy.  Establish rationale for approving inquires and appeals.
     
  • Assists with clinical research, writing documents, and documenting decisions.
     
  • Provide utilization management for prior authorization procedures.  Review cases and make decisions based on medical policy.  
     
  • Provide clinical support to various areas of the organization.  Process requests for clarification, interpretation, or questions about policy or benefits.  Review potential impacts of clinical matters.
     
  • Serves as clinical resource and subject matter expert to both clinical and non-clinical staff.
     
  • Perform clinical reviews and conduct peer to peers.
     
  • Participate in JUMP committee meetings.
     

"Qualifications"

  • Doctorate from an accredited school of medicine (M.D.) or osteopathy (D.O) required.
     
  • Seven (7) years clinical practice experience.
     
  • Current unrestricted state of Michigan Doctor of Medicine (M.D.) or doctor of osteopathy (D.O.) license.
     
  • Board certified or board eligible and working towards certification in a specialty approved by the American Board of Medical Specialists or the American Board of Osteopathy.
     
  • Proven leadership, problem solving, and the ability to manage multiple priorities.
     
  • Strong teaching and communication skills. 
     
  • Results oriented and the ability to take ownership for initiatives and collaborate with cross-functional teams to achieve department and corporate goals.
     
  • Demonstrated skill with Microsoft Office Suite and web-based programs.
     
  • Understanding of health plan functions related to utilization, care, and quality management.
     
  • Other related skills and/or abilities may be required to perform this job.
 
Department Summary / Preferences:
Specialty Care Knowledge is preferred.
Medical Policy Experience is a plus.
 

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
 

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