Global Medical Affairs Director at ViiV Healthcare ensuring effective communication of HIV prevention research. Leading training and data compliance efforts for clinical specialists and outside health care providers.
About the role
- Medical Director overseeing clinical operations in post-acute care for Elevance Health. Responsible for medical necessity decisions and clinical case reviews, ensuring timely medical decisions.
Responsibilities
- Ensures timely completion of clinical case reviews for their board certified specialty
- Makes physician to physician calls to gather medical appropriate information
- Makes medical necessity determinations for grievance and appeals appropriate for their specialty
- Ensures consistent use of company medical policies when making medical necessity decisions
- Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation
Requirements
- Requires MD/DO
- Board certification approved by ABMS or AOA
- Must possess an active unrestricted medical license to practice medicine
- Minimum of 1 year of experience with clinical case reviews for medical necessity
- Board certification in a medical specialty required
- 3 years of clinical experience post residency preferred
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- Paid Time Off
- wellness programs
- financial education resources
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