Position Title : Associate Medical Director - Genetic Testing
Carelon MBM - Genetic Testing
Location : Alternate locations may be considered. The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations although this is a work from home eligible position.
Shift : Monday – Friday; 8.5-hour shifts between 7am – 7pm CT (later shift hours preferred)
The Clinical Operations Associate Medical Director is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers.
How you will make an impact :
* Ensures timely completion of clinical case reviews for their board-certified specialty.
* Makes physician to physician calls to gather medically appropriate information in order to make medical necessity determinations for services requested.
* Makes medical necessity determinations for grievances and appeals appropriate for their specialty.
* Ensures consistent use of medical policies when making medical necessity decisions.
* Brings to their supervisor's attention any case review decisions that require Medical Director review or policy interpretation.
Minimum Requirements :
* Requires an MD and Board certification in a medical specialty.
Preferred skills, capabilities, and experiences :
* Internal medicine specialist preferred.
Salary Range : For candidates working in person or remotely in the below location(s), the salary range for this specific position is $196,598 to $307,732.
Locations : California
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).
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