Clinical Ops Associate Medical Director Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.
Work schedule: Monday – Friday 8:30am to 5:00pm depending on your zone.
This job is paid on an hourly basis. A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
The Clinical Ops 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 a MD and Board certification in a medical specialty.Preferred Skills, Capabilities and Experiences: Minimum of 3 years of Microsoft Office experience highly preferred.Strong written and oral communication skills preferred.For candidates working in person or remotely in the below location(s), the hourly range for this specific position is $82.19 to $146.76.
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).
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.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to any status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ****** for assistance.
#J-18808-Ljbffr