Associate Medical Director
| Company | Elevance Health |
|---|---|
| Location | Indianapolis, IN, USA, Newport Beach, CA, USA, Chicago, IL, USA, Atlanta, GA, USA |
| Salary | $188051 – $294910 |
| Type | Full-Time |
| Degrees | MD |
| Experience Level | Senior, Expert or higher |
Requirements
- Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
- Must possess an active unrestricted medical license to practice medicine or a health profession.
Responsibilities
- Ensures timely completion of clinical case reviews for their board-certified specialty.
- Makes physician to physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested.
- Makes medical necessity determinations for grievance and appeals appropriate for their specialty.
- Ensures consistent use of medical policies when making medical necessity decisions.
- Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation.
Preferred Qualifications
-
No preferred qualifications provided.