Virtual Medical Director — Health Plan Quality & Innovation

Elevance Health; Indianapolis (IN); Remote; USD 248,000 - 428,000; Full time

Job summary

Elevance Health seeks a Medical Director to oversee medical services for a national accounts client base. The role allows virtual work with required in-person training and occasional travel.

The Medical Director will lead utilization management, advise on clinical operations, and identify cost-to-care opportunities to improve value for members and clients. Requirements include an MD or DO with ABMS/AOA board certification, active unrestricted license, and 10 years of clinical experience.

Qualifications

• MD/DO degree with board certification by ABMS/AOA is required where applicable.
• Active unrestricted medical license to practice medicine or health profession.
• Minimum of 10 years of clinical experience or equivalent education/experience.

Responsibilities

• Works independently with oversight from the immediate manager.
• Provides utilization management support to national client care teams.
• Guides clinical operational aspects for client(s).
• Conducts peer-to-peer clinical reviews with attending physicians.
• Two two-week blocks of primary/back up call per year for regulatory turn-around-time.
• Serves as a resource and consultant for other areas of the company.
• Represents the company to clients and committees.
• Interprets medical policies and clinical guidelines.
• Directs and implements clinical activities impacting quality, cost, and outcomes.
• Identifies opportunities for innovation to improve effectiveness.

Skills

Health plan exp

Oncology review

Genetic testing review

Pediatric review

Surgical review

Internal medicine review

Education

MD/DO degree

ABMS/AOA board cert

Job description

Elevance Health seeks a Medical Director to oversee medical services for a national accounts client base. The role allows virtual work with required in-person training and occasional travel.

The Medical Director will lead utilization management, advise on clinical operations, and identify cost-to-care opportunities to improve value for members and clients. Requirements include an MD or DO with ABMS/AOA board certification, active unrestricted license, and 10 years of clinical experience.