Highmark Seeking Members for the Medical Review Committee 2027-28 Term

Highmark is seeking members to serve on its Medical Review Committee for the next two-year term of 2027-2028. Applicants should send in their resume or curriculum vitae (CV) by April 17, 2026.

Highmark’s Medical Review Committee resolves disputes between health service providers and Highmark. These disputes may involve utilization and quality of care issues, as well as alleged violations of participating provider agreements and appeals regarding network terminations. The Committee also considers and reviews appeals for providers who have been denied privileges to provide imaging services.

Currently serving on the Committee are four doctors of medicine, one doctor of osteopathy, one doctor of chiropractic, one physical therapist, and two consumer representatives. The Medical Review Committee Selection Committee appoints the members to a two-year term. Members may be re-appointed.

Responsibilities

The Medical Review Committee generally meets four times a year via a Zoom video conference call. Committee members receive an honorarium from Highmark for meeting participation.  

Considerable preparation time for the meetings may be required. Members are expected to attend all meetings and be prepared to participate in each case discussion.

Committee Member Requirements and How to Apply

All potential candidates must be a Pennsylvania licensed health care provider who is a party to one or more professional provider contracts with Highmark.

If you are interested in being considered for membership by the Medical Review Committee Selection Committee, please send a copy of your current resume or CV, by April 17 to:

Stephanie Smith
Secretary, Medical Review Committee
Financial Investigations and Provider Review
Highmark Inc.
120 Fifth Avenue
FAPHM-202D
Pittsburgh, PA 15222

-or-

Stephanie.R.Smith@highmark.com