Medical Director leading evidence generation strategies for neuroscience with a focus on innovative solutions and regulatory challenges in global medical affairs. Collaborates with cross - functional teams to enhance patient access and clinical practice.
About the role
- Medical Director responsible for managing clinical operations and providing strategic advice at Elevance Health. Overseeing health services and ensuring quality and cost-effectiveness in care delivery.
Responsibilities
- Responsible for the administration of physical and/or behavioral health medical services
- Provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations
- Conduct peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations
- Serve as a resource and consultant for other areas of the company
- Parses through medical policies and clinical guidelines
- Lead, develop, direct, and implement clinical and non-clinical activities that impact health care quality cost and outcomes
Requirements
- Requires MD or DO and Board certification approved by one of the following certifying boards is required
- Must possess an active unrestricted medical license to practice medicine or a health profession
- A minimum of 10 years of clinical experience
- For Health Solutions and Carelon organizations (including behavioral health) only, a minimum of 5 years of experience providing health care is required
- Experience caring for patients in following specialties: Pediatrics, Family Practice, Emergency Medicine, Internal Medicine, and Physical Medicine are strong preferred
- Double board-certified in Pediatrics and Internal Medicine is a plus
- 3-5 years of Utilization Management Review experience strongly preferred
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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