Sr. Medical Director, FEP Utilization Management

Sr. Medical Director, FEP Utilization Management at Blue Shield of California summary: The Senior Medical Director for FEP Utilization Management leads clinical review activities and physician processes supporting utilization management and transactional functions for Federal Employee Program members. This role oversees pre-service and retrospective utilization reviews, appeals, grievances, and provider claim disputes while driving compliance, performance management, and clinical quality improv…