New

Executive Medical Director - Federal Employee Program

Health Care Service Corporation
life insurance, parental leave, paid time off, paid holidays, tuition reimbursement, 401(k)
United States, Texas, Richardson
1001 East Lookout Drive (Show on map)
Aug 30, 2025
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for planning and implementation of medical policies and programs and strategic involvement with the cost of health care for accounts with more than 800,000 federal employee members across 5 states. This position is primarily accountable for advising and implementing quality improvement initiatives, medical guidelines, management of high-cost claimants, 2nd level prior authorization and claim reviews and process improvements. In addition, to various degrees, this position will perform physician level review using applicable systems and maintain effective relationships with physicians, hospitals, and medical service companies to respond to and resolve problems, serving as the final decision maker for clinical determination. This position will also head projects to promote effective policy relative to the membership of the Federal Employee Program in partnership with the Blue Cross Blue Shield Association. Please note, this is a HYBRID position which requires in-office hours 3 times a week at the respective location. JOB REQUIREMENTS: * Physician (M.D. or D.O) with a current and unrestricted physician license in a state or territory of the United States * Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists * 5 years of post-graduate patient care/clinical experience. * 5 years of managed care experience coupled with proven experience in the application of medical problems to managed care practices. * Knowledge of current medical and surgical techniques, reimbursement methodology, and benefit management. * Leadership skills to lead groups to consensus and resolution building aligned to corporate strategy * Demonstrated ability to independently make tough strategic decisions and move forward with actions on the strategies. * Strong verbal and written communication skills. * Experience achieving results through people. * Experience being proactive and highly results oriented; able to meet deadlines under pressure. * Experience thinking innovatively and developing process improvements to align with business strategies. * Experience being the subject matter expert/leader in a specified field. * Experience presenting and negotiating. * Strategic thinking skills. * Proficiency in computer use (including software applications such as Microsoft Office Products) needed for electronic documentation of case reviews * Overseeing the annual budget and allocating resources for various projects and operational needs. * Translating needs and initiatives into compelling business cases. * Conducting cost-benefit analyses to justify investments and ensure ROI. PREFERRED EXPERIENCE: * Experience developing business strategies, leading broad medical policy initiatives. * Proficient in data analytics and reporting, including the capability to collaborate and direct analysts with novel queries. #LI-Hybrid #LI-AZ1 Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, 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, 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 employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan. HCSC Employment 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. Base Pay Range$210,600.00 - $391,100.00 Exact compensation may vary based on skills, experience, and location.