- 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.
-
Medical Director
1 week ago
Liberty Healthcare Corporation Nashville, United States Part timeJob Description · Due to anticipated organizational growth, Liberty Healthcare seeks qualified candidates for a potential new part-time Medical Director position. · This is a virtual administrative role which does not involve direct patient care. This position offers a flexible s ...
-
Medical Director
1 week ago
PSG Global Solutions Nashville, United StatesSHIFT: 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 ...
-
Medical Director
3 weeks ago
Lucent Health Solutions LLC Nashville, United StatesJob Description · Job DescriptionMedical 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 some ...
-
Medical Director
3 weeks ago
Spero Health Nashville, United StatesProvide supervision of all medical staff at a clinic facility and the administration of all medical services at the clinic facility, including compliance with all federal, state, and local laws and regulations regarding the medical treatment of opioi Medical Director, Director, M ...
-
Medical Director
3 weeks ago
Spero Health Nashville, United StatesJob Type Part-timeDescriptionSpero Health is seeking a Medical Director to join our Tennessee teamThis part-time administrative position is for a Medical Director to join our team to help us fulfill our mission to "Saving Lives, Instilling Hope, and Restoring Relationships". Our ...
-
Medical Director
6 days ago
Humana, Inc. Nashville, United StatesBecome a part of our caring community and help us put health first · The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires a ...
-
Medical Director
5 days ago
Elevance Health Nashville, United StatesElevance 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 ...
-
Medical Director
5 days ago
Staff Icons Nashville, United StatesWe 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 ...
-
Medical Director
1 week ago
Envision Healthcare Nashville, United StatesJob 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 ...
-
Medical Director
3 weeks ago
Envision Healthcare Nashville, United StatesJob Details · 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 a ...
-
Medical Director
3 weeks ago
Envision Healthcare Nashville, United StatesJob Details · 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 a ...
-
Director Medical
3 weeks ago
Oasis Center Nashville, TN, United States: · LEVEL: Director · JOB TITLE: Director of Grants · PROGRAM AREA: Development · FSLA STATUS: Exempt · JOB OBJECTIVE: To assist agency leadership in developing a broad base of support (federal, state, foundation, and philanthropic) for the services provided by Oasis Center. ...
-
UM Medical Director
1 week 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 ...
-
Collaborative Medical Director
2 weeks ago
Healogics, Inc. Nashville, United States Part timeHealogics 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 ...
-
Center Medical Director
3 weeks ago
ChenMed Nashville, United StatesWe're unique. You should be, too. · We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? · We're different than ...
-
Director of Medical Coding
3 weeks ago
Tennessee Orthopaedic Alliance Nashville, United States Full time: · Tennessee Orthopaedic Alliance is the largest orthopedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advanc ...
-
Associate Medical Director
5 days ago
Elevance Health Nashville, United StatesClinical Operations Associate Medical DirectorCarelon Medical Benefit ManagementInterventional Pain Benefit ReviewLocation · : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locat ...
-
Associate Medical Director
6 days ago
Elevance Health Nashville, United StatesClinical Operations Associate Medical Director · Carelon Medical Benefit Management · Interventional Pain Benefit Review · Location · : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePo ...
-
National Medical Director
1 week ago
Elevance Health Nashville, United StatesAnticipated 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 ...
-
Market Medical Director
1 hour ago
ConcertoCare Nashville, United StatesJob 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 ...
National Medical Director - Nashville, United States - Elevance Health
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.
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.
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 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 $449,424
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.