UNKNOWN

ADAPTED_NOW

The purpose of a Primary Care Physician at Oak Street Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care centers. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

YEAR

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Primary Care Physician Company: Oak Street Health Role Description: The purpose of a Primary Care Physician at Oak Street Health is to provide equitable and effective value-based healthcare to local Medicare patient populations at our innovative network of neighborhood primary care centers. Our Primary Care Physicians operate at a single medical center supported by large care teams so our providers can focus on delivering a better quality of care, rather than a volume of services. Our value-based care model and competitive bonuses are structured to reward outcomes, drive low hospital admissions, deliver preventive medicine, and result in an unmatched patient experience. We’re looking for physicians who are intrinsically motivated to provide this kind of excellent care to older adults. New graduates are encouraged to apply. Highly qualified candidates may also be considered for a Center Medical Director position. Responsibilities: <ul><li> Assess and diagnose patients at our local clinics </li><li> Oversee, direct, and administer primary care </li><li> Prescribe and administer pharmaceutical treatments and medication </li><li> Maintain Patient Electronic Medical Record data via canopy and greenway </li><li> Collaborate with regional and central leadership to meet health quality goals </li><li> Work with Practice Managers to direct and manage the center care team </li><li> Other duties as assigned </li></ul> Required Qualifications: <ul><li> Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.) Graduate </li><li> Internal Medicine or Family Medicine Board Certification (Or board eligible)</li><li> Active, non-probationary, unrestricted State License </li><li> Active DEA license </li><li> US work authorization </li></ul> Preferred Qualifications: <ul><li> Fellowship training in Geriatrics </li><li> Experience practicing medicine among Geriatric populations </li><li> Experience operating in a Value-Based Healthcare Model </li><li> Experience working in a collaborative setting to ensure positive health outcomes </li><li> Experience in outpatient primary care settings </li><li> Bilingual proficiency where applicable </li></ul> Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $174,070.00 - $374,920.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.   Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: <ul><li> Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan . </li><li> No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. </li><li> Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. </li></ul> For more information, visit  We anticipate the application window for this opening will close on: 03/30/2027 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Oak Street Health

Family Medicine, Medical Doctor / Primary Care Physician

Biotech and Pharmaceutical

Coaching

Electronic Medical Records

Establish Priorities

Family Medicine

Fellowship

Geography

Geriatrics

Health Plan

Healthcare

Healthcare Administration

Leadership

Medical Diagnosis

Medicare

Medications

Osteopathy

Outpatient Care

Patient Assessment

Primary Care

Quality of Care

Safety/Work Safety

Stock Purchase Plans

Team Player

United States Drug Enforcement Agency (DEA)

Weight Management

Easy Hiring FTP

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._. + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards.

Company : Highmark Inc. 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: $170,000.00 Pay Range Maximum: $352,500.00 _Base 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 Req ID: J266916

Highmark Health

Medical Director

Company : Highmark Inc. 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: $170,000.00 Pay Range Maximum: $352,500.00 _Base 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 Req ID: J267780

Medical Director, Clinical Services

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