Medical Review Committee 2027-28: Applications Requested

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 Dec. 31, 2026.

Highmark’s Medical Review Committee resolves disputes between health service doctors 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.

Members of the Medical Review Committee are appointed by the Medical Review Committee Selection Committee to serve a two-year term and may be considered for reappointment.

Responsibilities

The Medical Review Committee generally meets four times a year via a Zoom video conference call. Committee members will receive compensation for their service, as determined by Highmark, for meeting participation.

Members of the Medical Review Committee are expected to attend meetings regularly and devote sufficient preparation time before each meeting to understand the matters under review and participate fully and fairly in Committee discussions and decisions.

Committee Member Eligibility Requirements

Highmark is particularly seeking physicians (M.D.s and D.O.s) licensed in Pennsylvania to serve on the Medical Review Committee for its upcoming term.

Interested candidates must meet the following eligibility requirements:

• Be participating in, or be employed by a provider that participates in, Highmark’s provider network.
• Not be a director, officer, or employee of Highmark Inc, or any of its affiliated entities, or a member of a Regional Advisory Board.
• Be able to fairly and impartially consider matters presented to the Committee.
• Be willing to regularly attend meetings and devote sufficient time to prepare for and fully consider the matters presented.

How to Apply

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 Dec. 31 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