Jobs
>
Nashville

    National Medical Director - Nashville, United States - Elevance Health

    Default job background
    Description

    Anticipated End Date:

    Position Title:
    National Medical Director - Total Cost of Care, Post Acute

    Job 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 is looking to hire a National Solution Medical Director for a set of Post Acute Care Solutions.

    This high-performing individual contributor will be responsible for serving as a National Solution Medical Director for our Post Acute Solutions Clinical Product Line, overseeing clinical integrity for the service line, supporting the product strategy and design, and implementing medical management approaches that impact healthcare quality, cost, and outcomes.

    Additional responsibilities include executing on the product strategy, managing solution performance and improving access to and usefulness of health improvement tools offered to our health plan clients and members.


    How you will make an impact:
    Develops clinical appropriateness guidelines for post-acute solutions.
    Monitors competitor products and internal medical management capabilities and responds with recommendations for improvement in company models.
    Contributes to the development of Medical Management and Quality Management strategies. Develops and enhances relevant clinical guidelines.

    Provides clinical leadership for Utilization Management, Case Management, Disease Management, and Quality Management of Clients in cooperation with solution medical directors and the Chief Medical Officer.

    Provides clinical expertise in sales planning and participates in the acquisition and retention of clients.
    Collaborates with HCM leaders to refine and improve provider and medical management services to meet the needs of Clients.
    Provides clinical expertise to relevant data analytic activities.
    Provides clinical expertise and strategic insight for solution development and expansion.
    Provides thought leadership in laboratory medicine and genetic testing.
    Communicates medical management trends and recommends company medical management responses to clients.
    Contributes to efforts to establish effective provider quality and cost profiling and education.
    Contributes to improved provider relationships and national associations and societies.
    Represents the company at nationally recognized speaking engagements to promote health programs.

    Requires an MD and minimum of 12 years of healthcare experience; or any combination of education and experience, which would provide an equivalent background.

    Requires current unrestricted medical licensure in applicable state(s). Board certification is required.

    Requires experience with population or segment health management and the education and coaching of members on wellness, prevention, and healthy lifestyles.


    Strongly Preferred:
    Certified with the American Board of Physical Medicine & Rehabilitation or Geriatrics and 12+ years of experience preferred.
    MBA and/or experience in Administrative Medicine, Business Strategy, Product Strategy.
    Experience with managing risk programs, ACO's, IPAs, at risk health systems. Population health management and whole person-end to end risk management.
    Benefits Management decision support experience in the Post-Acute Domain, DME, Home Health, and Wound Care.
    Experience with Clinical guideline research and development, medical necessity, and medical policy.
    Ability to travel ~10%.

    For candidates working in person or remotely in the below locations, the salary* range for this specific position is $249,680 to $449,424Locations:

    California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJIn 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.


    Job Level:

    Director EquivalentWorkshift:

    Job Family:MED > Licensed Physician/Doctor/DentistPlease 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 AreElevance 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 WorkAt 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
    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. 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.

  • STAFF ICONS, LLC

    Medical Director

    5 days ago


    STAFF ICONS, LLC Nashville, United States

    We are seeking a pathologist to act as a Medical Director · CALL OR TEXT KATHY @ · Qualifications · MD or DO degree plus accredited pathology residency · Must be board certified in anatomic and clinical pathology · 3+ years post residency experience desired · Ability to spend ...

  • Lucent Health Solutions, Inc.

    Medical Director

    3 days ago


    Lucent Health Solutions, Inc. Nashville, United States

    Job Description · Job Description · Medical Director · Temp contract 20-25 hrs/wkly · Remote · An actively practicing physician reviewer/advisor who holds a current, unrestricted license to practice medicine, has professional post-residency experience in direct patient care at ...

  • PSG Global Solutions

    Medical Director

    3 weeks ago


    PSG Global Solutions Nashville, United States

    SHIFT: Day Job SCHEDULE: Full-time Your Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were creating greater access to care for our members, greater value for our customers, and greater health for our Medical, Director, Health, Clin ...


  • Healogics, Inc. Nashville, United States Part time

    Healogics is hiring a Part-Time or PRN Collaborative Medical Director | Wound Care Physician for our Wound Care Center at St Thomas Midtown Hospital in Nashville, TN. Healogics is proud to offer Wound Care and Hyperbaric Oxygen (HBO) Therapy training. · Come Heal With Us · Schedu ...

  • Elevance Health

    UM Medical Director

    3 days ago


    Elevance Health Nashville, United States

    · This position will work a hybrid model (remote and office). Ideal candidates must live within 50 miles of one of our Elevance Health locations. · The Medical Director is responsible for the administration of physical and/or behavioral health medical services, to ensure the app ...

  • Elevance Health

    UM Medical Director

    3 weeks ago


    Elevance Health Nashville, United States

    · Wellpoint, formerly Amerigroup, is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative services to Medicaid plans in partnership with blue cross blue shield plans. · This position will wor ...


  • Monogram Health, Inc. Nashville, United States

    Practice Medical Director - Nashville, TN · Job Category · : · Clinical · Requisition Number · : · PRACT003152 · Apply now · Posted : April 23, 2024 · Full-Time · Locations · Showing 1 location · Description · Position: · Practice Medical Director · Lead the strategic tr ...


  • Envision Physician Services San Francisco, United States Permanent

    New Nashville Medical Director Anesthesiologist Opportunity Incredible PTO, Case Mix and Work/Life Balance Exceptional Start Date Bonus · Nashville Anesthesia Services, Envision Physician Services Provider is seeking a full-time anesthesiologist to join our team at TriStar South ...


  • Elevance Health Nashville, United States

    Anticipated End Date: · Position Title: · National Medical Director - Total Cost of Care, Post Acute · Job Description: · A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management lea ...

  • Elevance Health

    Medical Director

    2 weeks ago


    Elevance Health Nashville, United States

    Elevance Health · Medical Director · Nashville , · Tennessee · Apply Now · At · Federal Health Products and Services - FHPS · , a proud member of the Elevance Health, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greate ...

  • Staff Icons

    Medical Director

    2 weeks ago


    Staff Icons Nashville, United States

    We are seeking a pathologist to act as a Medical Director · CALL OR TEXT KATHY @ · Qualifications · MD or DO degree plus accredited pathology residency · Must be board certified in anatomic and clinical pathology · 3+ years post residency experience desired · Ability to spend co ...

  • Envision Healthcare

    Medical Director

    3 weeks ago


    Envision Healthcare Nashville, United States

    Job DetailsNew Nashville Medical Director Anesthesiologist Opportunity Incredible PTO, Case Mix and Work/Life Balance Exceptional Start Date BonusNashville Anesthesia Services, Envision Physician Services Provider is seeking a full-time anesthesiologist to join our team at TriSta ...


  • DCI Donor Services Nashville, TN, United States Full time

    DCI Donor Services · DCI Donor Services (DCIDS) is looking for a dynamic and enthusiastic team member to join us to save lives We are currently seeking a Director of Information Technology to direct the design of IT systems to maximize organizational efficiency and lead to more ...


  • Cytokinetics Nashville, United States

    We view our employees as the unequivocal ingredients to success. Every employee is an integral member of the Cytokinetics team, contributing to our shared goal of improving lives. While expectations of our employees are high, there is an equal commitment to ensuring that contribu ...


  • Tristar Health Nashville, TN, United States

    Critical Care Pulmonary · Critical Care Anesthesiology · Critical Care Internal Medicine · Critical Care Emergency Medicine · Intensive Care Consortium (ICC) Healthcare is seeking a Critical Care Intensivist Facility Medical Director to lead the TriStar Skyline Medical Center ...


  • Elevance Health Nashville, United States

    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 ...


  • ConcertoCare Nashville, United States

    Job Type · Full-time · Description · The ConcertoCare Medical Director manages clinical care delivery and performance in the market in collaborative partnership with the Market Operations Leader. Key activities include support and oversight of clinical care delivered by field-b ...


  • AMN Healthcare, Inc. Nashville, TN, United States

    Job Description & Requirements · Service Medical Director, Molecular Genetics Laboratories · StartDate: ASAP Pay Rate: $ $ Vanderbilt University Medical Center is seeking a Medical Director for the Molecular Genetics Service Work for a Prestigious University Drive Discovery an ...


  • AMN Healthcare, Inc. Nashville, TN, United States

    Service Medical Director, Molecular Genetics Laboratories · StartDate: ASAP Pay Rate: $230000.Vanderbilt University Medical Center is seeking a Medical Director for the Molecular Genetics Service Work for a Prestigious University Drive Discovery and Improve Care of Patients Nash ...


  • The Curare Group Nashville, United States

    Inpatient Adult and Child/Adolescent Psychiatry job with 18-20 panel case load. Work on a Monday-Friday schedule with manageable call and extra pay for any weekend call. Salary is negotiated based on candidate's training and experience. Lucrative salary and medical director stipe ...