Elevance Health
Associate Medical Director - Genetic Testing Utilization Review
Elevance Health, Gilbert, Minnesota, United States, 55741
Anticipated End Date:
2024-09-20Position Title:
Associate Medical Director - Genetic Testing Utilization ReviewClinical 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.A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology, and oncology.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.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).Job Level:
Non-Management Non-ExemptWorkshift:
1st Shift (United States of America)Job Family:
MED > Licensed Physician/Doctor/DentistPlease 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.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.
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2024-09-20Position Title:
Associate Medical Director - Genetic Testing Utilization ReviewClinical 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.A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology, and oncology.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.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).Job Level:
Non-Management Non-ExemptWorkshift:
1st Shift (United States of America)Job Family:
MED > Licensed Physician/Doctor/DentistPlease 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.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.
#J-18808-Ljbffr