Health Care Service Corporation

Regional Medical Director- (Nashville,TN)

Health Care Service Corporation • $191K — $355K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in medical policy and program management
  • Strong background in clinical leadership and utilization review
  • Expertise in population health and value-based care initiatives
  • Proven ability to influence quality and performance metrics
  • Familiarity with risk adjustment and market-level outcomes

Responsibilities

  • Conduct medical reviews for assigned areas
  • Engage with provider communities to enhance collaboration
  • Lead advanced clinical strategies across medical management programs
  • Integrate utilization review with population health initiatives
  • Align medical policy with clinical strategy to drive performance

Benefits

  • Health and wellness benefits
  • 401(k) savings plan and pension plan
  • Minimum of 15 days of paid time off
  • Paid parental leave and disability insurance
  • Tuition reimbursement and employee assistance program
  • Paid holidays and additional incentives
Full Job Description
Job Summary
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.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

Pay Transparency Statement:

At CareAllies, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From 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, plus other incentives, we offer a robust total rewards package for full-time employees.

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 the conditions of the plan.

Min to Max Range:
$191,500.00 - $355,600.00

Exact compensation may vary based on skills, experience, and location.

About Health Care Service Corporation

Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the United States. HCSC offers a wide variety of health insurance products and related services, through its operating divisions and subsidiaries in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC's headquarters is located in Chicago, Illinois.
Learn more about Health Care Service Corporation
Size
24,000 employees
Industry
Founded
1936

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