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Associate Medical Director - AIM/Carelon Insights

Company: Elevance Health
Location: Oklahoma City
Posted on: March 19, 2023

Job Description:

Clinical Operations Associate Medical Director AIM Specialty Health/Carelon Insights Remote/Work From Home- Location Flexible AIM Specialty Health is a benefit-management leader in Illinois and a proud member of Elevance Health's family of companies. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. Job Summary: Responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. Primary duties may include, but are not limited to:

  • 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. Desired Skills and Abilities:
    • Requires an MD and Board certification in a medical specialty required. For candidates working in person or remotely in the below locations, the salary* range for this specific position is $158,725 to $285,692. Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws . * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Keywords: Elevance Health, Oklahoma City , Associate Medical Director - AIM/Carelon Insights, Executive , Oklahoma City, Oklahoma

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