Medical Director - Post Acute Care

Position Overview

Clinical Operations Medical Director – Carelon Medical Benefits Management, Post Acute Care Benefit Utilization Management.

10:00AM-7:00PM CT on weekdays / 7:00AM-4:00PM CT on weekend coverage day. One weekend day coverage required.

Part Time and Full Time options available to include a weekend day.

Virtual:
This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across clinical domains including radiology, cardiology and oncology.

• Supports the medical management staff ensuring timely and consistent medical decisions to members and providers.
• Ensures timely completion of clinical case reviews for board-certified specialties.
• Makes physician-to-physician calls to gather medical information to determine medical necessity for services requested.
• Makes medical necessity determinations for grievances and appeals appropriate for their specialty.
• Ensures consistent use of company medical policies when making medical necessity decisions.
• Brings to supervisors any case review decisions that require Medical Director review or policy interpretation.

• MD/DO with board certification approved by ABMS or AOA where applicable.
• Active unrestricted medical license to practice medicine or health profession.
• Minimum of 1 year of experience with clinical case reviews for medical necessity (waived for Cardiology, Oncology, and Interventional Pain specialties).
• Board certification in a medical specialty required.

• 3 years of clinical experience post-residency, preferably in inpatient post-acute care.
• Board certified in Physical Medicine and Rehabilitation (preferred).

Salary range for candidates in the listed locations is $179,503 to $307,732. Locations:
California, Illinois, Nevada, Washington State.

Elevance Health offers a comprehensive benefits package including incentive programs, equity, 401(k) contributions, and more. The salary range is provided in good faith at posting and may vary by location, experience, and market conditions.

The salary and benefits are subject to applicable policies. No wage or compensation is determined until earned and vested.

Please note Elevance Health only accepts resumes from agencies with a signed agreement. Unsolicited resumes are the property of Elevance Health.

Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company focused on growth, inclusion, and delivering results for our members, associates, and communities.

Equal Employment Opportunity:
Elevance Health is an equal opportunity employer. Applicants will be considered without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, gender identity or expression, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status protected by law. Accommodation requests in the job application process may be directed to elevancehealthj Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.