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Medical Director – Oncology
Elevance HealthAppeals Medical Director for Oncology overseeing appeal reviews and ensuring cost-effective medical care at Elevance Health. Developing programs to improve healthcare quality and outcomes.
Posted 5/27/2026full-timeCalifornia, Illinois, Maryland, New Jersey, New York, Ohio, Virginia • 🇺🇸 United StatesLead💰 $247,840 - $446,112 per yearWebsite
About the role
Key responsibilities & impact- Responsible for appeal reviews for physical health medical services
- Ensure the appropriate and most cost-effective medical care is received
- Develop and implement programs to improve quality, cost, and outcomes
- Provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations
- Identify cost of care opportunities
- Supports clinicians to ensure timely and consistent responses to members and providers
- Provides guidance for clinical operational aspects of a program
- Conduct peer-to-peer clinical case reviews with attending physicians or other ordering providers
- Serve as a resource and consultant for other areas of the company
Requirements
What you’ll need- Requires MD or DO and Board certification approved by 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 10 years of clinical experience; or any combination of education and experience that would provide an equivalent background
- For Health Solutions and Carelon organizations, minimum of 5 years of experience providing health care is required
- Board certification in Oncology or Hematology and Oncology strongly preferred
- Utilization Management or Appeals experience preferred
Benefits
Comp & perks- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- merit increases
- paid holidays
- Paid Time Off
- medical benefits
- dental benefits
- vision benefits
- short and long term disability benefits
- wellness programs
- financial education resources
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical consultationpeer-to-peer clinical case reviewscost of care analysisprogram developmentquality improvementclinical operations enhancementutilization managementappeals process
Soft Skills
strategic advisingguidancesupporting clinicianstimely communicationcollaboration
Certifications
MDDOBoard certificationAmerican Board of Medical Specialties (ABMS)American Osteopathic Association (AOA)active unrestricted medical licenseBoard certification in OncologyBoard certification in Hematology and Oncology