Medical Director – Genetic Testing, Oncology

Elevance Health

Medical Director overseeing genetic testing in oncology at Elevance Health. Responsible for utilization case reviews and providing clinical education with clinical criteria.

Posted 5/5/2026full-timeChicago • California, Illinois, Maryland • 🇺🇸 United StatesLead💰 $291,200 - $524,160 per yearWebsite

About the role

Key responsibilities & impact

Determines the medical necessity of requests using clinical criteria
Performs physician-level case review of oncologic utilization requests
Conducts peer-to-peer consultation with ordering physicians
Provides education regarding applicable clinical criteria
Performs first level provider appeals for coverage decisions
Provides support and education to internal clinical and non-clinical staff
Participates in physician team meetings
Participates in groups that develop, revise and enhance clinical appropriateness guidelines

Requirements

What you’ll need

Requires MD and/or DO
completion of training in Oncology, or related board certification
Requires a current, valid, active and unrestricted medical license(s)
Requires a minimum of 5 years of clinical experience
Experience with utilization management, especially with CMS guidelines preferred

Benefits

Comp & perks

comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution
Paid Time Off
medical, dental, vision
short and long term disability benefits
wellness programs
financial education resources

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical criteriaoncologic utilization reviewpeer-to-peer consultationprovider appealsutilization management

Soft Skills

educationsupportteam collaboration

Certifications

MDDOOncology board certificationmedical license