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Insurance Medical Director Jobs in O Fallon, IL (NOW HIRING)

Gentiva Hospice

Medical Director

Saint Louis, MO · On-site

We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert ... Medical, Dental, Vision Insurance * Mileage Reimbursement or Fleet Vehicle Program * Generous Paid ...

Gentiva

Hospice Medical Director

Saint Louis, MO · On-site

We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert ... Medical, Dental, Vision Insurance * Mileage Reimbursement or Fleet Vehicle Program * Generous Paid ...

Concentra

Physician Medical Director

Saint Louis, MO · On-site

At Concentra, our Medical Directors spend most of their time clinically treating patients; the ... Insurance - Colleague Referral Bonus Program - Unmatched potential to grow your career, whether it ...

Concentra

Physician Medical Director

Saint Louis, MO · On-site

At Concentra, our Medical Directors spend most of their time clinically treating patients; the ... Insurance - Colleague Referral Bonus Program - Unmatched potential to grow your career, whether it ...

Concentra

Physician Medical Director

Saint Louis, MO · On-site

Concentra is seeking a Physician Medical Director to join our team in St. Louis, MO! Are you ... Insurance - Colleague Referral Bonus Program - Unmatched potential to grow your career, whether it ...

Concentra

Physician Medical Director

Saint Louis, MO · On-site

Concentra is seeking a Physician Medical Director to join our team in St. Louis, MO! Are you ... Insurance - Colleague Referral Bonus Program - Unmatched potential to grow your career, whether it ...

TeamHealth

Medical Director job in Shiloh IL

Shiloh, IL · On-site

$40K/yr

As medical director, you'll play a key role in building a program from the ground up by managing a ... insurance with tail coverage - Mentorship opportunities to support your clinical development ...

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Insurance Medical Director information

See O Fallon, IL salary details

$12.1K

$216.8K

$333K

How much do insurance medical director jobs pay per year?

As of Sep 1, 2026, the average yearly pay for insurance medical director in O Fallon, IL is $216,755.00, according to ZipRecruiter salary data. Most workers in this role earn between $184,700.00 and $265,400.00 per year, depending on experience, location, and employer.

What does an Insurance Medical Director do?

An Insurance Medical Director is a physician who reviews medical claims, evaluates policyholder cases, and ensures treatments align with insurance guidelines. They analyze complex medical information to determine coverage eligibility and assess the necessity of procedures. They also collaborate with claims adjusters, underwriters, and other medical professionals to ensure fair and accurate decision-making. Their role helps insurance companies manage risk while maintaining compliance with healthcare regulations.

What are the typical daily responsibilities of an Insurance Medical Director?

Insurance Medical Directors typically review medical claims, assess prior authorization requests, and provide clinical guidance on complex cases to ensure that coverage decisions comply with current medical standards and company policies. They also collaborate closely with underwriters, case managers, and other healthcare professionals, participating in multidisciplinary meetings and developing policies for medical management. Additionally, Insurance Medical Directors may engage in quality improvement initiatives, conduct peer reviews, and assist in training staff on clinical procedures and regulatory changes. The role requires a balance of high-level decision-making, medical expertise, and effective communication with both internal teams and external providers.

What are the key skills and qualifications needed to thrive in the Insurance Medical Director position?

To thrive as an Insurance Medical Director, you need a medical degree (MD or DO), board certification, clinical expertise, and experience with healthcare regulations and utilization review. Familiarity with claims management systems, ICD-10 coding, and tools like Milliman or InterQual guidelines is often required. Strong analytical skills, clear written and verbal communication, and the ability to make objective decisions are essential soft skills. These competencies are crucial for ensuring ethical, evidence-based determinations that balance patient care with organizational and regulatory requirements.

What job categories do people searching Insurance Medical Director jobs in O Fallon, IL look for?

The top searched job categories for Insurance Medical Director jobs in O Fallon, IL are:

What cities near O Fallon, IL are hiring for Insurance Medical Director jobs?

Cities near O Fallon, IL with the most Insurance Medical Director job openings:

Insurance Medical Director jobs near you
Infographic showing various Insurance Medical Director job openings in O Fallon, IL as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $216,755 per year, or $104.2 per hour.

Medical Director

Gentiva Hospice

Saint Louis, MO • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 12 days ago

Gentiva Health Services rating

7.2

Company rating: 7.2 out of 10

Based on 142 frontline employees who took The Breakroom Quiz

26th of 245 rated social care providers

Job description

Overview
Expand Access. Build Partnerships. Transform Care through Compassionate Hospice Leadership.
We are seeking a dedicated Hospice Medical Director to join our leadership team and provide expert clinical oversight to our hospice physicians. In this critical role, you will ensure the delivery of compassionate, goal-directed care to hospice patients while upholding the highest standards of medical practice. You will collaborate with interdisciplinary teams, oversee regulatory compliance, and guide quality improvement efforts to enhance patient outcomes.
*** This position will have oversight out our branches in St. Louis, Farmington, Washington, Wentzville, and Jefferson City***
Key Responsibilities:
  • Oversee and ensure quality medical services delivered by hospice physicians across multiple locations.
  • Certify and recertify hospice eligibility, ensuring timely compliance with Medicare and other regulations.
  • Conduct and supervise face-to-face patient visits, including home consultations for complex cases.
  • Lead physician recruitment, training, supervision, and performance evaluation.
  • Provide 24/7/365 on-call physician coverage coordination with hospice physicians.
  • Maintain accurate, timely medical documentation and support regulatory reviews.
  • Participate actively in interdisciplinary group (IDG) meetings to coordinate patient care and medication management.
  • Monitor pharmacy utilization, ensuring appropriate medication prescribing and administration.
  • Collaborate with hospice leadership on policy development, compliance, and quality assessment and performance improvement (QAPI) initiatives.
  • Serve as a community liaison, enhancing hospice visibility and partnerships with healthcare providers.
  • Support educational programs for staff, physicians, and community partners.

About You
Qualifications:
  • Doctorate degree in allopathic or osteopathic medicine from an accredited medical school.
  • Board certification in a specialty recognized by ABMS or AOA-BOS, preferably primary care.
  • Current and unrestricted medical license in the practicing state.
  • Valid National Provider Identifier (NPI) and DEA registration for controlled substances.
  • Hospice and Palliative Medicine board certification and/or Hospice Medical Director Certification Board certification preferred.
  • Current Medicare Provider Enrollment (PECOS) and Medicaid certification if required.
  • Ability to travel 15-25% based on program needs.
  • CPR and TB clearance required.

Specialized Knowledge and Skills:
  • Extensive knowledge of hospice and palliative care principles, regulations, and best practices.
  • Leadership and mentorship skills to inspire interdisciplinary teams and improve patient care.
  • Strong organizational skills to manage multiple priorities and regulatory requirements.
  • Compassionate communication and empathy toward patients and families facing end-of-life situations.
  • Proficiency in navigating healthcare compliance, quality improvement, and ethical considerations.
  • Ability to collaborate effectively with attending physicians, staff, and community healthcare providers.
  • Excellent verbal and written communication skills.

Personal Traits:
  • Passion for providing exceptional palliative care and advocacy for hospice patients.
  • Positive reputation in the medical community with a commitment to collaborative practice.
  • Flexibility and adaptability to dynamic healthcare environments.
  • Commitment to maintaining professional standards and compliance with hospice regulations.

We Offer
Benefits for All Associates (Full-Time, Part-Time & Per Diem):
  • Competitive Pay
  • 401(k) with Company Match
  • Career Advancement Opportunities
  • National & Local Recognition Programs
  • Teammate Assistance Fund

Additional Full-Time Benefits:
  • Medical, Dental, Vision Insurance
  • Mileage Reimbursement or Fleet Vehicle Program
  • Generous Paid Time Off + 7 Paid Holidays
  • Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care)
  • Education Support & Tuition Assistance (ASN to BSN, BSN to MSN)
  • Free Continuing Education Units (CEUs)
  • Company-paid Life & Long-Term Disability Insurance
  • Voluntary Benefits (Pet, Critical Illness, Accident, LTC)

Apply now to make a lasting impact in hospice medicine and advance your career in a supportive, mission-driven environment.
Legalese
  • This is a safety-sensitive position
  • Employee must meet minimum requirements to be eligible for benefits
  • Where applicable, employee must meet state specific requirements
  • We are proud to be an EEO employer
  • We maintain a drug-free workplace

Location
Gentiva Hospice
Our Company
At Gentiva, it is our privilege to offer compassionate care in the comfort of wherever our patients call home. We are a national leader in hospice care, palliative care, home health care, and advanced illness management, with nearly 600 locations and thousands of dedicated clinicians across 38 states.
Our place is by the side of those who need us - from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis.
Our nationwide reach is powered by a family of trusted brands that include:
  • Hospice care: Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon
  • Palliative care: Empatia Palliative Care, Emerald Coast Palliative Care
  • Home health care: Heartland Home Health
  • Advanced illness management: Illumia Health

With corporate headquarters in Atlanta, Georgia, and providers delivering care across the U.S., we are proud to offer rewarding careers in a collaborative environment where inspiring achievements are recognized - and kindness is celebrated.

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