Elevance Health
Associate Medical Director - Genetic Testing Utilization Review JR129100
Elevance Health, Charleston, West Virginia, United States,
Clinical Operations Associate Medical DirectorCarelon HealthGenetics Testing Utilization ReviewLocation : The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations but will have options for work from home.Schedule:
Monday - Friday, 9 AM-5:30 PM in time zone candidate resides.Position Overview:
The
Clinical Operations Associate Medical Director
is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers.How you will make an impact:Ensures timely completion of clinical case reviews for their board certified specialty.Makes physician to physician calls to gather medically 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 supervisor's attention any case review decisions that require Medical Director review or policy interpretation.Minimum Requirements:Requires an MD and Board certification in a medical specialty.Preferred Skills, Capabilities, and Experiences:Primary Care/Internal Medicine Board Certification preferred.Knowledge/Experience in Genetic Testing preferred but not required.Compact License or residing in a Compact State strongly preferred.Salary Information:
For candidates working in person or remotely in the below location(s), the salary range for this specific position is $162,801 to $293,055.Locations:
California; Colorado; District of Columbia (Washington, DC); Maryland; Nevada; New York; Washington State.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).Company Overview:
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.Equal Opportunity Employer:
Elevance Health is an Equal Employment Opportunity employer. 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.
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Monday - Friday, 9 AM-5:30 PM in time zone candidate resides.Position Overview:
The
Clinical Operations Associate Medical Director
is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers.How you will make an impact:Ensures timely completion of clinical case reviews for their board certified specialty.Makes physician to physician calls to gather medically 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 supervisor's attention any case review decisions that require Medical Director review or policy interpretation.Minimum Requirements:Requires an MD and Board certification in a medical specialty.Preferred Skills, Capabilities, and Experiences:Primary Care/Internal Medicine Board Certification preferred.Knowledge/Experience in Genetic Testing preferred but not required.Compact License or residing in a Compact State strongly preferred.Salary Information:
For candidates working in person or remotely in the below location(s), the salary range for this specific position is $162,801 to $293,055.Locations:
California; Colorado; District of Columbia (Washington, DC); Maryland; Nevada; New York; Washington State.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).Company Overview:
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.Equal Opportunity Employer:
Elevance Health is an Equal Employment Opportunity employer. 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.
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