Remote Medical Director – Clinical Programs Lead (Contract)

Elevance Health; United States; Hybrid; USD 180,000 - 240,000; Full time

Benefits offered by this job

Hybrid work

Contract through 2027

Competitive benefits

Job summary

Elevance Health is seeking a Physician Medical Director to oversee clinical operations and provide strategic guidance across medical services. The role emphasizes quality, cost, and outcomes, with opportunities to influence programs and policies.

Requires MD or DO with ABMS/AOA board certification, an active unrestricted license, and at least 10 years of clinical experience (5+ years for Health Solutions if applicable).

Qualifications

• MD or DO with ABMS/AOA board certification required.
• Active unrestricted medical license required.
• Minimum of 10 years of clinical experience; 5+ years for Health Solutions/Carelon roles where applicable.

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 to discuss review determinations.
• May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.
• Serves as a resource and consultant to other areas of the company.
• May chair company committees.
• Interprets medical policies and clinical guidelines.
• May develop and propose new medical policies based on changes in healthcare.
• Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes.
• Identifies and develops opportunities for innovation to increase effectiveness and quality.

Skills

Clinical leadership

Communication skills

Peer reviews

Education

MD or DO with ABMS/AOA board certification

Job description

Elevance Health is seeking a Physician Medical Director to oversee clinical operations and provide strategic guidance across medical services. The role emphasizes quality, cost, and outcomes, with opportunities to influence programs and policies.

Requires MD or DO with ABMS/AOA board certification, an active unrestricted license, and at least 10 years of clinical experience (5+ years for Health Solutions if applicable).