Remote Medical Director - Clinical Innovation & Leadership

Elevance Health; Washington; Remote; USD 273,000 - 428,000; Full time

Benefits offered by this job

Hybrid/Virtual work

Job summary

Elevance Health seeks a Medical Director – Ameriben to lead medical services, quality, cost, and outcomes across clinical programs, with potential program development and clinical consultation to enhance operations.

Requirements include MD/DO with board certification and an active unrestricted medical license, plus 10+ years of clinical experience. This remote/virtual role may require in-person training and occasional travel, centered in Mountain Time Zone considerations.

Qualifications

• MD/DO and board certification required with active unrestricted medical license.
• Must be located in the United States when conducting utilization review or appeals considerations.

Responsibilities

• Supports clinicians to ensure timely and consistent responses to members and providers.
• Provides guidance for clinical operational aspects of a program.
• Conducts peer-to-peer clinical reviews with attending physicians or other providers.
• Serves as a resource and consultant to other areas of the company.
• Represents the company to external entities and/or committees.
• Chairs company committees.
• Interprets medical policies and clinical guidelines.
• Develops and proposes new medical policies based on changes in healthcare.
• Leads and implements clinical and non-clinical activities impacting quality and cost.

Skills

Utilization management

Clinical leadership

Policy interpretation

Communication with clinicians

Program development

Education

MD/DO

Board certification

Tools

MCG criteria

Carelon criteria

Anthem criteria

Job description

Elevance Health seeks a Medical Director – Ameriben to lead medical services, quality, cost, and outcomes across clinical programs, with potential program development and clinical consultation to enhance operations.

Requirements include MD/DO with board certification and an active unrestricted medical license, plus 10+ years of clinical experience. This remote/virtual role may require in-person training and occasional travel, centered in Mountain Time Zone considerations.