Senior Medical Director providing leadership for Lupus medical strategy at Biogen. Collaborating across functions to deliver impactful medical insights and strategies for clinical development.
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
Job title
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