Medical Director Associate

🔥 0 minutes ago

🐊 Florida, North Carolina, +2 more states – Remote

🐊 Florida – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🤠 Texas – Remote

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Elevance Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Elevance Health is transforming from a traditional health benefits organization into a lifetime trusted health partner, driven by a bold purpose to improve the health of humanity. With nearly 100,000 associates, they serve over 118 million people and utilize an integrated whole health approach supported by industry-leading capabilities and a digital health platform. Their mission includes redefining health, reimagining the health system, and strengthening communities.

📋 Description

• Support pharmacy prior authorization reviews to meet turnaround times and comply with Pharmacy Benefit Management regulatory requirements • Provide clinical guidance for pharmacy prior authorizations using CarelonRx clinical guidelines • Support clinicians in providing timely and consistent responses to members and providers • Conduct peer-to-peer prior authorization reviews for medications with attending physicians or other ordering providers • Participate in a physician on-call weekend rotation for a 24x7 unit

🎯 Requirements

• MD or DO required • Board certification approved by the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA), where applicable to duties performed • Active unrestricted medical license to practice medicine or a health profession • Must be located in a state or territory of the United States when conducting utilization review or appeals consideration, unless expressly allowed by law or regulation • Cannot be located on a US military base, vessel, or embassy when conducting utilization review or appeals consideration • Minimum of 5 years of clinical experience, or an equivalent combination of education and experience • Utilization management experience preferred • Willingness to participate in a physician on-call weekend rotation for a 24x7 unit

🏖️ Benefits

• Merit increases • Paid holidays • Paid Time Off • Incentive bonus programs • Medical benefits • Dental benefits • Vision benefits • Short-term disability benefits • Long-term disability benefits • 401(k) with match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources • Virtual full-time work arrangement, except for required in-person training sessions