Senior Medical Director, Clinical UM Operations - Waukesha, United States - Elevance Health

Elevance Health Waukesha, United States

2 weeks ago

Description

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois.

Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.
Carelon Medical Benefits Management Clinical Operations team is looking to hire a

Senior Medical Director

to manage a team of physicians performing clinical coverage and determination reviews for our Musculoskeletal (MSK) Solution

(internal title:

Manager Clinical Operations Medical Director)

Responsible for providing day-to-day guidance, support, and leadership for the clinical and quality activities and supporting the Medical Directors in ensuring the clinical integrity of broad and significant clinical programs.

Position can work 1 day a week from any Elevance Health US corporate location.

How you will make an impact:

Provides support to clinicians in daily tasks and participates in peer-to-peer discussions and office visits with providers and external physicians as necessary.

May participate in a physician on-call rotation for a 24x7 pre-certification unit.

Assists in the practitioner appeal reviews, appropriateness criteria reviews, medical policy and technology assessments, setting and implementing QI initiatives, and practitioner/provider credentialing.

Hires,trains, coaches, counsels, and evaluates performance of direct reports.

Requires MD or DO. Minimum of 5 years clinical experience with expertise in medical management required. Board certification is required where applicable to the duties being performed.

Preferred:

Leadership experience managing teams of physicians in a utilization management clinical operations business inside a health plan or a UM/benefits management firm.
Proven experience leading change management initiatives
Experience with Commercial, Medicaid, and Medicare lines of business

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $211,040 to $379,872

Locations:
California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

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.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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