What are the responsibilities and job description for the Medicare Medical Director position at Elevance Health?
Elevance Health Medicare Medical Director Hanover, Maryland Apply Now
Location : This position will work a hybrid model (remote and office). The ideal candidate must live within 50 miles of one of our Elevance Health PulsePoint locations.
Candidates must be able to work Eastern Time Zone hours.
The Medicare Medical Director is responsible for the administration of physical and / or behavioral health medical services to ensure the appropriate and most cost-effective medical care is received. Responsibilities include developing and implementing programs to improve quality, cost, and outcomes, providing clinical consultation, and serving as a clinical / strategic advisor to enhance clinical operations.
How you will make an impact :
- Supports clinicians to ensure timely and consistent responses to members and providers.
- Provides guidance for clinical operational aspects of a program.
- Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations and patients’ office visits.
- May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers.
- Serves as a resource and consultant to other areas of the company.
- May represent the company to external entities and / or serve on internal and / or external committees.
- May chair company committees.
- Interprets medical policies and clinical guidelines.
- May develop and propose new medical policies based on changes in healthcare.
- Leads, develops, directs, and implements clinical and non-clinical activities that impact healthcare quality, cost, and outcomes.
- Identifies and develops opportunities for innovation to increase effectiveness and quality.
Minimum Requirements :
For candidates working in person or remotely, the salary range for this position is $240,576 to $378,048. Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes are deemed to be the property of Elevance Health.
Who We Are :
Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry.
How We Work :
At Elevance Health, we are creating a culture that is designed to advance our strategy and lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture.
Elevance Health operates in a Hybrid Workforce Strategy. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. Elevance Health is an Equal Employment Opportunity employer.
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Salary : $240,576 - $378,048
