Appeals Medical Director for Elevance Health responsible for clinical reviews in neurology. Ensuring cost-effective medical care through developing quality improvement programs and clinical consultation.
Responsibilities
responsible for appeal reviews for physical health medical services
ensure appropriate and cost-effective medical care is received
develop and implement programs to improve quality, cost, and outcomes
provide clinical consultation and serve as clinical/strategic advisor
Requirements
Requires MD or DO and Board certification approved by ABMS or AOA
Must possess an active unrestricted medical license to practice medicine
Minimum of 10 years of clinical experience
For Health Solutions and Carelon organizations, minimum of 5 years of experience providing health care required
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