Post-Acute Medical Director (Virtual, Part-Time)

Elevance Health; United States; Remote; USD 210,000 - 310,000; Part time

Benefits offered by this job

Sign-on bonus $10,000

Job summary

Elevance Health is seeking a Medical Director for Post Acute Care to oversee medical management staff and ensure timely, consistent medical decisions for members and providers. The role supports Carelon Medical Benefits Management in post-acute care utilization management.

The position requires MD/DO with ABMS/AOA board certification and an active medical license, with at least one year of clinical case review experience.

Qualifications

• MD/DO with ABMS or AOA board certification.
• Active unrestricted medical license to practice medicine.
• Minimum of 1 year of experience with clinical case reviews for medical necessity, waived for Cardiology, Oncology, and Interventional Pain specialties.
• Board certification in a medical specialty is required.
• Preferred: Board certified in Physical Medicine and Rehab.

Responsibilities

• Ensures timely completion of clinical case reviews for their board-certified specialty.
• Makes physician-to-physician calls to gather medical information to determine medical necessity.
• Makes medical necessity determinations for grievances and appeals for their specialty.
• Ensures consistent use of company medical policies when making medical necessity decisions.
• Brings to supervisors’ attention any case review decisions that require MD review or policy interpretation.

Education

MD/DO degree with ABMS/AOA board certification

Job description

Elevance Health is seeking a Medical Director for Post Acute Care to oversee medical management staff and ensure timely, consistent medical decisions for members and providers. The role supports Carelon Medical Benefits Management in post-acute care utilization management.

The position requires MD/DO with ABMS/AOA board certification and an active medical license, with at least one year of clinical case review experience.