Associate Medical Director Post Acute Care

Anticipated End Date :

Position Title :

Associate Medical Director - Post Acute Care

Job Description :

Clinical Operations Associate Medical Director

Carelon Medical Benefits Management

Post Acute Care Benefit Utilization Management

Schedule : 10 : 00AM-7 : 00PM CT on Weekdays / 7 : 00AM-4 : 00PM CT on weekend coverage day. One weekend day coverage required.

Part Time and Full Time options available to include a weekend day.

Virtual : This role enables associates to work virtually full-time with the exception of required in-person training sessions providing maximum flexibility and autonomy. This approach promotes productivity supports work-life integration and ensures essential face-to-face onboarding and skill development

Please note that per our policy on hybrid / virtual work candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

A proud member of the Elevance Health family of companies Carelon Post Acute Solutions formerly myNEXUS is the leader in health resource optimization focused on transforming how healthcare is delivered and promoting the advancement of care for the people we serve.

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 medical appropriate information in order to make medical necessity determinations for services requested.

Makes medical necessity determinations for grievance and appeals appropriate for their specialty.

Ensures consistent use of medical policies when making medical necessity decisions.

Brings to their supervisors attention any case review decisions that require Medical Director review or policy interpretation.

Minimum Requirements :

Requires MD or DO and Board certification approved by one of the following certifying boards is required where applicable to duties being performed American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).

Must possess an active unrestricted medical license to practice medicine or a health profession.

Preferred Experience Qualifications and Capabilities :

3 years of clinical experience post residency. Preferably in inpatient post-acute care

Board certified in Physical Medicine and Rehab is preferred.

For candidates working in person or vitually in the below location(s) the salary

• range for this specific position is $179503 to $307732.

Locations :

California Illinois Nevada Washington State

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). The salary offered for this specific position is based on a number of legitimate non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws .

Job Level :

Non-Management Non-Exempt

Workshift :

1st Shift (United States of America)

Job Family : MED >

Licensed Physician / Doctor / Dentist

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.

We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Required Experience :

Director

Key Skills

EMR Systems,Post Residency Experience,Occupational Health Experience,Clinical Research,Managed Care,Primary Care Experience,Medical Management,Utilization Management,Clinical Development,Clinical Trials,Leadership Experience,Medicare

Employment Type : Part-Time

Experience : years

Vacancy : 1

Monthly Salary Salary : 179503 - 307732