Medical Director - Radiation Oncology

Radiation Oncology

Clinical Operations Medical Director – Carelon Medical Benefit Management – Virtual.

This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. 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.

• Ensures timely completion of clinical case reviews for their board‑certified specialty.
• Makes physician‑to‑physician calls to gather medically 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 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.

• Requires MD or DO and Board certification approved by one of the following certifying boards:
  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.
• Minimum of 1 year of experience with clinical case reviews for medical necessity. The minimum of 1 year of experience with clinical case reviews would be waived for the following specific specialties only;
  Cardiology, Oncology, and Interventional Pain specialties. Board certification in a medical specialty required.

• Board certified in Radiation Oncology strongly preferred.

For candidates working in person or virtually in the below location(s), the salary range for this specific position is $225,036 to $352,236.

California;
District of Columbia (Washington, DC), New Jersey, New York.

In addition to your salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution. Benefits are subject to eligibility requirements and may vary by location and position.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, and local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance.