Elevance Health
Medical Director
Elevance Health, Las Vegas, Nevada, us, 89105
Anticipated End Date2024-09-23
Position TitleMedical Director
Job DescriptionAt
Federal Health Products and Services - FHPS , a proud member of the Elevance Health, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
Location:
This is a Hybrid position and preferred candidates must reside within 50 miles of an Elevance Health PulsePoint location.
Hours:
Monday through Friday 8 am - 5 pm MST, PST or CST.
ResponsibilitiesSupports clinicians to ensure timely and consistent responses to members and providers.Guides clinical operational aspects of a program.Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations and patient's office visits with providers and external physicians.May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.Serves as a resource and consultant to other areas of the company.May be required to represent the company to external entities and/or serve on internal and/or external committees.May chair company committees. Interprets medical policies and clinical guidelines.May develop and propose new medical policies based on changes in healthcare.Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost, and outcomes.Identifies and develops opportunities for innovation to increase effectiveness and quality.Works independently with oversight from immediate manager.May be responsible for an entire clinical program and/or independently perform clinical reviews.The Medical Director typically has program management responsibilities including clinical policy development, program development/implementation, and overseeing clinical/non-clinical activities.
Minimum RequirementsRequires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, 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.Unless expressly allowed by state or federal law or regulation, must be located in a state or territory of the United States when conducting a utilization review or an appeals consideration and cannot be located on a US military base, vessel, or any embassy located in or outside of the US.Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. For Health Solutions and Carelon organizations (including behavioral health) only, a minimum of 5 years of experience providing health care is required.Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency.
Preferred Skills, Capabilities, And ExperiencesUtilization Management experience is a plus.Ability to meet necessary internet speed requirements and adhere to work-at-home agreements.
Job LevelDirector Equivalent
Workshift1st Shift (United States of America)
Job FamilyMED > Licensed Physician/Doctor/Dentist
Who We AreElevance 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 WorkAt 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.
Salary InformationFor candidates working in person or remotely in the below locations, the salary range for this specific position is $218,232 to $342,936. Locations: Colorado; Nevada.
Equal Opportunity EmployerElevance 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.#J-18808-Ljbffr
Position TitleMedical Director
Job DescriptionAt
Federal Health Products and Services - FHPS , a proud member of the Elevance Health, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
Location:
This is a Hybrid position and preferred candidates must reside within 50 miles of an Elevance Health PulsePoint location.
Hours:
Monday through Friday 8 am - 5 pm MST, PST or CST.
ResponsibilitiesSupports clinicians to ensure timely and consistent responses to members and providers.Guides clinical operational aspects of a program.Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations and patient's office visits with providers and external physicians.May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.Serves as a resource and consultant to other areas of the company.May be required to represent the company to external entities and/or serve on internal and/or external committees.May chair company committees. Interprets medical policies and clinical guidelines.May develop and propose new medical policies based on changes in healthcare.Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost, and outcomes.Identifies and develops opportunities for innovation to increase effectiveness and quality.Works independently with oversight from immediate manager.May be responsible for an entire clinical program and/or independently perform clinical reviews.The Medical Director typically has program management responsibilities including clinical policy development, program development/implementation, and overseeing clinical/non-clinical activities.
Minimum RequirementsRequires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, 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.Unless expressly allowed by state or federal law or regulation, must be located in a state or territory of the United States when conducting a utilization review or an appeals consideration and cannot be located on a US military base, vessel, or any embassy located in or outside of the US.Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. For Health Solutions and Carelon organizations (including behavioral health) only, a minimum of 5 years of experience providing health care is required.Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency.
Preferred Skills, Capabilities, And ExperiencesUtilization Management experience is a plus.Ability to meet necessary internet speed requirements and adhere to work-at-home agreements.
Job LevelDirector Equivalent
Workshift1st Shift (United States of America)
Job FamilyMED > Licensed Physician/Doctor/Dentist
Who We AreElevance 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 WorkAt 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.
Salary InformationFor candidates working in person or remotely in the below locations, the salary range for this specific position is $218,232 to $342,936. Locations: Colorado; Nevada.
Equal Opportunity EmployerElevance 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.#J-18808-Ljbffr