Remote Associate Medical Director — Genetic Testing

The Elevance Health Companies, Inc.; Cerritos (CA); Hybrid; USD 257,256,000 - 422,619,000; Full time

Benefits offered by this job

Comprehensive benefits package

401(k) plan + matching

Stock purchase program

Incentive/recognition programs

Job summary

Elevance Health is seeking an Associate Medical Director for Genetic Testing to oversee clinical operations, support medical management decisions, and collaborate with internal medicine and genetics teams. The role emphasizes medical policy adherence and timely case reviews to ensure optimal member care.

Hybrid/virtual work is supported with required in-person training sessions. A Board-certified MD/DO with an unrestricted license is required, with Family/Internal Medicine background preferred.

Qualifications

• MD/DO with board certification (ABMS/AOA) is required.
• Active unrestricted medical license to practice medicine.

Responsibilities

• Ensure timely completion of clinical case reviews for the board-certified specialty.
• Make physician-to-physician calls to gather information for medical necessity determinations.
• Make medical necessity determinations for grievances and appeals per specialty.
• Ensure consistent use of medical policies when making medical necessity decisions.
• Flag cases needing Medical Director review or policy interpretation.

Skills

MD/DO

Board certification

Medical license

Family Medicine

Education

MD/DO degree

Job description

Elevance Health is seeking an Associate Medical Director for Genetic Testing to oversee clinical operations, support medical management decisions, and collaborate with internal medicine and genetics teams. The role emphasizes medical policy adherence and timely case reviews to ensure optimal member care.

Hybrid/virtual work is supported with required in-person training sessions. A Board-certified MD/DO with an unrestricted license is required, with Family/Internal Medicine background preferred.