[Hiring] Associate Medical Director @Elevance Health

Role Description

The Clinical Operations Associate Medical Director is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers.

• Ensures timely completion of clinical case reviews for their board certified specialty.
• Makes physician to physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested.
• Makes medical necessity determinations for grievance and appeals appropriate for their specialty.
• Ensures consistent use of medical policies when making medical necessity decisions.
• Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation.

Qualifications

• Requires MD or DO and Board certification approved by one of the following certifying boards: American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
• Must possess an active unrestricted medical license to practice medicine or a health profession.
• 3 years of clinical experience post residency, preferably in inpatient post-acute care.
• Board certified in Physical Medicine and Rehab is preferred.

Requirements

• Schedule: 11:00AM-8:00PM CT. Will also require one weekend coverage shift a month.
• This role enables associates to work virtually full-time, with the exception of required in-person training sessions.
• Alternate locations may be considered if candidates reside within a commuting distance from an office.
• Per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (subject to eligibility requirements).
• Merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
• Medical, dental, vision, short and long term disability benefits.
• Life insurance, wellness programs, and financial education resources.