Remote Medical Director — Clinical Ops & Policy

Elevance Health, Inc.; Meridian (ID); Remote; USD 273,000 - 428,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase plan

401(k) contribution

Job summary

Elevance Health is seeking a Medical Director for Ameriben in a mostly remote role with required in-person training sessions. The position oversees medical services, policy development, and clinical program leadership across the organization.

Candidates should have an MD/DO with active license and significant clinical leadership experience. The role includes supervision, policy interpretation, and potential chairing of committees, with salary guidance provided for Colorado, Illinois, and

Qualifications

• MD/DO with active unrestricted license to practice medicine.
• Minimum 10 years of clinical experience or equivalent background.
• Preferred: Additional state licensing or willingness to obtain.
• Experience with utilization management and policy criteria (MCG, Carelon, Anthem) is helpful.

Responsibilities

• Supports clinicians to ensure timely responses to members and providers.
• Guides clinical operational aspects of programs.
• Conducts peer-to-peer clinical reviews with physicians or other providers.
• Serves as a resource to other areas of the company.
• Represents the company on internal and external committees.
• Chairs company committees.
• Interprets medical policies and clinical guidelines.
• Develops and proposes new medical policies based on healthcare changes.
• Leads clinical and non-clinical activities impacting quality, cost, and outcomes.
• Identifies opportunities for innovation to increase effectiveness and quality.
• Evening and weekend coverage on rotation.

Skills

Utilization management

MCG/Carelon/Anthem criteria

Oncology review

Genetic testing review

Musculoskeletal review

State licensing

Education

MD/DO with ABMS/AOA board certification

Job description

Elevance Health is seeking a Medical Director for Ameriben in a mostly remote role with required in-person training sessions. The position oversees medical services, policy development, and clinical program leadership across the organization.

Candidates should have an MD/DO with active license and significant clinical leadership experience. The role includes supervision, policy interpretation, and potential chairing of committees, with salary guidance provided for Colorado, Illinois, and