Medical Director, Tisotumab Vedotin
Pfizer
Medical Director
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Walnut Creek • California, New York • 🇺🇸 United States
Visit company websiteSalary
💰 $226,404 - $428,976 per year
Job Level
Lead
About the role
- Responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received.
- Develops and implements programs to improve quality, cost, and outcomes.
- Provides clinical consultation and serves as clinical/strategic advisor to enhance clinical operations.
- Identifies cost of care opportunities.
- Serves as a resource to staff including Medical Director Associates.
- May be responsible for an entire clinical program.
- 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 with providers and external physicians.
- May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.
- Interprets medical policies and clinical guidelines.
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.
- A minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- For Health Solutions and Carelon organizations (including behavioral health) only, a minimum of 5 years of experience providing health care is required.
- Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a State agency.
- 1-2 years Utilization Management experience strongly preferred.
- Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
clinical consultationclinical operationspeer-to-peer clinical reviewsclinical appeal case reviewsmedical policy interpretationquality improvementcost managementoutcomes improvementbehavioral health experienceUtilization Management
Soft skills
oral communicationwritten communicationinterpersonal communicationproblem-solvingfacilitationanalytical skills
Certifications
MDDOBoard certificationactive unrestricted medical license
