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Medical Director

Health Care Service Corporation · Chicago, IL · Remote available · $191,500–$355,600 a year · Full time

Posted Sep 11, 2026 · We last checked this listing on Oct 6, 2026

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Likely interview questions for this role

Written from this job description, not a generic list. Each one notes what the interviewer is really checking.

About your past

You have five years of clinical practice. What made you want to move into managed care, and what do you expect to miss?

What they are checking: Whether they have made peace with reviewing charts instead of treating patients and understand the role honestly.

Tell me about a time you disagreed with a colleague on a clinical decision. How did it resolve?

What they are checking: Whether they can disagree based on evidence without making it personal, which happens often among reviewers.

This is a remote role with electronic case documentation. How do you stay focused and accurate reviewing records all day from home?

What they are checking: Self-discipline and accuracy habits when working alone on high-volume, detailed review.

What would you do

You are reviewing an appeal and the treating physician's notes are strong, but the request does not meet our medical policy criteria. How do you decide?

What they are checking: How they balance policy consistency with clinical judgment and when they would flag a policy that may be out of date.

How would you handle a peer-to-peer call with a frustrated specialist who believes a denial is hurting their patient?

What they are checking: Whether they can stay respectful and clinical with providers while still explaining a decision clearly.

The posting mentions cardiology, oncology and rheumatology. How do you handle an appeal in a specialty outside your own board certification?

What they are checking: Whether they know the limits of their expertise and use specialty matched reviewers or literature rather than guessing.

Appeals have regulatory turnaround times. How would you manage a heavy queue when some cases are expedited?

What they are checking: Whether they understand that urgent appeals have strict clocks and can triage without cutting corners.

About the work

This role focuses on appeals. Walk me through how you review an appeal of a denied service from start to decision.

What they are checking: Whether they read the full record, apply the stated medical policy, and document a decision that would hold up on external review.

How do you write the rationale on an appeal decision so that the member, the provider and a regulator can all understand it?

What they are checking: Clear written documentation, since appeal letters are read by non-clinicians and reviewed in audits.

How do you keep current with medical evidence so that the policies you apply reflect current standards of care?

What they are checking: Whether they read guidelines and literature actively, which matters when policy criteria lag behind practice.

Practice this interview out loud.

Offer builds a real interview for this exact role at Health Care Service Corporation from your resume and this job description, asks the questions one at a time, and tells you what landed. The first one is free.

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The full job description

As published by Health Care Service Corporation.

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 assigned aspects of medical policies and programs. Performs medical reviews and interacts with the provider communities for assigned areas. 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 clinical experience • Analytical and communication skills • Strategic thinking skills • Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews PREFERRED REQUIREMENTS: • 3 years Managed Care experience • Speciality preference Rheumatology, Neurology, Oncology, Internal Medicine or Family Medicine This is a work from home Remote position #LI-MG1 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 plan subject 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 $191,500.00 - $355,600.00 Exact compensation may vary based on skills, experience, and location.

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