Remote Associate Medical Director, DMEPOS

The Elevance Health Companies, Inc.

Nashville (TN)

Hybrid

USD 240,000 - 360,000

Full time

6 days ago

Be an early applicant

Application generator

Turn this role into an interview — a resume and cover letter built around what this employer wants.

Get past ATS filters

Job summary

Elevance Health is seeking an Associate Medical Director for DMEPOS to lead medical necessity determinations and clinical reviews. This full-time role is largely virtual with required in-person training sessions, and a hybrid work option within commuting distance of an office.

Applicants must hold an MD or DO with ABMS or AOA board certification and an unrestricted license. Board certification in Family Medicine, Internal Medicine, or PM&R is preferred; alternate locations may be considered per

Qualifications

MD/DO with ABMS or AOA board certification.
Active unrestricted medical license to practice medicine or a health profession.
Board certification in Family Medicine, Internal Medicine, or PM&R preferred.

Responsibilities

Ensures timely completion of clinical case reviews for their board certified specialty.
Makes physician to physician calls to gather medical 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 supervisors attention, any case review decisions that require Medical Director review or policy interpretation.