Elevance Health
Medical Director - Carelon Product
Elevance Health, Nashville, Tennessee, United States, 37247
Medical Director- Carelon Product
Location: This position will work a hybrid model (remote and office). The Ideal candidate will must live within 50 miles of one of our Elevance Health PulsePoint locations.
Build the Possibilities. Make an extraordinary impact.
Responsible for collaborating with and providing clinical leadership to product managers designing and implementing clinical programs with specific medical condition focus for all lines of business enterprise wide. Analyzes and interprets data in collaboration with data and analytics to identify opportunities. Partners with LOB (line of business) and Market leaders to ensure clinical solutions align with membership health priorities. Collaborates with payment innovation on clinical programs that support providers in value-based payment arrangements. Serves as a subject matter expert/collaborator with leaders and other clinical initiatives including cost of care.
How you will make an impact:
Co-Designs product solutions that drive performance in support of the innovation and execution of Carelon solutions.
Provides clinical expertise, captures and shares best practices across regions to provider partners as well as the company’s medical directors by way of studying designs, analytics and reporting for clinical quality that drives improved healthcare outcomes.
Provides an end-to-end clinical solution by taking a problem from initiation to execution with reporting and analytics as an outcome.
Accountable for achieving performance results in value-based care by engaging, influencing and supporting physicians.
Engages with providers in joint operating committees and builds relationships with clinical leadership of provider collaboration groups.
Promotes clinical best practice sharing across all lines of business to improve results and drive efficiency and effectiveness.
Works to develop and deliver high impact interventions, supporting content development and practice transformation embedded capabilities to significantly improve provider performance that drive cost of care and improve HEDIS/Stars where applicable.
Minimum Requirements:
Requires an M.D.
Also requires BA/BS in health-related field and minimum of 10 years of experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted medical license in applicable state(s) required.
Board certification in a medical specialty required.
Preferred Skills, Capabilities, and Experiences:
Advanced knowledge in health care systems and health policy, quality measures, performance measurement, and quality improvement, and the clinical understanding for clinical quality programs strongly preferred.
Six Sigma or formal process improvement experience preferred.
Analytical experience in creating study designs, ROIs and statistical techniques preferred.
MBA or equivalent business degree preferred.
Experience working with product managers and business teams preferred.
Ability to lead via influence across multiple teams preferred.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $262,164 to $449,424.
Locations: California and New York.
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Location: This position will work a hybrid model (remote and office). The Ideal candidate will must live within 50 miles of one of our Elevance Health PulsePoint locations.
Build the Possibilities. Make an extraordinary impact.
Responsible for collaborating with and providing clinical leadership to product managers designing and implementing clinical programs with specific medical condition focus for all lines of business enterprise wide. Analyzes and interprets data in collaboration with data and analytics to identify opportunities. Partners with LOB (line of business) and Market leaders to ensure clinical solutions align with membership health priorities. Collaborates with payment innovation on clinical programs that support providers in value-based payment arrangements. Serves as a subject matter expert/collaborator with leaders and other clinical initiatives including cost of care.
How you will make an impact:
Co-Designs product solutions that drive performance in support of the innovation and execution of Carelon solutions.
Provides clinical expertise, captures and shares best practices across regions to provider partners as well as the company’s medical directors by way of studying designs, analytics and reporting for clinical quality that drives improved healthcare outcomes.
Provides an end-to-end clinical solution by taking a problem from initiation to execution with reporting and analytics as an outcome.
Accountable for achieving performance results in value-based care by engaging, influencing and supporting physicians.
Engages with providers in joint operating committees and builds relationships with clinical leadership of provider collaboration groups.
Promotes clinical best practice sharing across all lines of business to improve results and drive efficiency and effectiveness.
Works to develop and deliver high impact interventions, supporting content development and practice transformation embedded capabilities to significantly improve provider performance that drive cost of care and improve HEDIS/Stars where applicable.
Minimum Requirements:
Requires an M.D.
Also requires BA/BS in health-related field and minimum of 10 years of experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted medical license in applicable state(s) required.
Board certification in a medical specialty required.
Preferred Skills, Capabilities, and Experiences:
Advanced knowledge in health care systems and health policy, quality measures, performance measurement, and quality improvement, and the clinical understanding for clinical quality programs strongly preferred.
Six Sigma or formal process improvement experience preferred.
Analytical experience in creating study designs, ROIs and statistical techniques preferred.
MBA or equivalent business degree preferred.
Experience working with product managers and business teams preferred.
Ability to lead via influence across multiple teams preferred.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $262,164 to $449,424.
Locations: California and New York.
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.