Full-Time Sr Medical Director – Utilization Management
Wellmark, Inc. is hiring a remote Full-Time Sr Medical Director – Utilization Management. The career level for this job opening is Senior Manager and is accepting Cedar Rapids, IA based applicants remotely. Read complete job description before applying.
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Wellmark, Inc.
Job Title
Sr Medical Director – Utilization Management
Posted
Career Level
Full-Time
Career Level
Senior Manager
Locations Accepted
Cedar Rapids, IA
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Job Details
If not within a commutable distance to a Wellmark office, you will be eligible to work remotely from your home location, with the expectation of travel to the Des Moines, Iowa office. Candidates within driving distance or a direct flight to Des Moines, Iowa are preferred. Central Time Zone preferred.
About the opportunity: As Senior Medical Director for Utilization Management (UM), you will be an effective change leader and help develop and guide the strategic direction for Utilization Management initiatives at Wellmark. As a leader of others, you will directly impact the success, growth, and development of team members.
About you: You believe health care can be better and are passionate about finding ways to influence this important work. You are proactive, analytical, innovative, and partner effectively with internal and external stakeholders. You are a skilled communicator and enjoy collaboration with other cross-functional leaders. You are someone who can pivot easily: from performing UM and appeals case reviews, to driving employee engagement and collaboration amongst your team and others, to strategically partnering to develop new total cost of care (TCOC) initiatives.
Required Qualifications:
- M.D. or D.O. degree.
- Active and unrestricted license to practice medicine in Iowa and/or South Dakota is required within 3 months from date of hire OR an administrative license; must be licensed in the state in which you reside.
- Current Board Certification approved by the American Board of Medical Specialties or American Osteopathic Association.
- 5+ years of adult inpatient clinical experience in an acute care hospital setting.
- 3+ years of prior experience in a formal or informal administrative leadership role in a healthcare environment.
What you will do:
- Demonstrate ownership of overall effectiveness and efficiency of UM process and outcomes.
- Demonstrate deep expertise in delivering UM inpatient and outpatient decisions, especially on complex cases.
- Provide leadership and day-to-day management of financial and human resources, primarily focusing on employee and leader coaching, development, performance improvement, coordination and budgeting for multiple staff, and department specific functions/services.
- Responsible to perform oversight of independent review organization appeals.
- Responsible for providing exemplary engagement on peer-to-peer calls and escalated UM cases.
- Partners with and demonstrate effectiveness with Wellmark’s Business Analytics team to drive each component of product development/new total cost of care (TCOC) initiatives to reduce overuse.
- Perform other initiatives and projects as required.
FAQs
What is the last date for applying to the job?
The deadline to apply for Full-Time Sr Medical Director – Utilization Management at Wellmark, Inc. is
3rd of December 2025
. We consider jobs older than one month to have expired.
Which countries are accepted for this remote job?
This job accepts [
Cedar Rapids, IA
] applicants. .
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