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Medical Director – Post Acute Care
Elevance HealthMedical Director overseeing clinical operations in Post Acute Care at Elevance Health. Ensuring timely medical decisions and adherence to medical necessity policies while leading a clinical management team.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical case reviews and medical necessity determinations, ensuring adherence to company medical policies and effective communication with medical staff. Holds an active medical license and board certification in a relevant specialty, with a commitment to timely and accurate medical decision-making.
Highest-signal resume keywords
MD/DOBoard CertificationActive Unrestricted Medical LicenseClinical Case ReviewsMedical Necessity Determinations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical Case ReviewsMedical Necessity DeterminationsGrievance and Appeals ManagementPolicy Interpretation
Soft Skills
Effective CommunicationAttention to Detail
Certifications & Qualifications
Board Certification Approved by ABMS or AOA
Industry Keywords
Medical ManagementMedical PoliciesPhysician to Physician Calls
About the role
Key responsibilities & impact- Supports medical management staff ensuring timely and consistent medical decisions
- Ensures timely completion of clinical case reviews for board certified specialty
- Makes physician to physician calls to gather medical appropriate information for medical necessity determinations
- 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 supervisors attention any case review decisions that require Medical Director review or policy interpretation
Requirements
What you’ll need- Requires MD/DO and Board certification approved by ABMS or 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
- Board certification in a medical specialty required
Benefits
Comp & perks- Sign on bonus: $10,000
- Flexible work arrangements
- Competitive salary and total rewards package including merit increases, paid holidays, and Paid Time Off
- Incentive bonus programs
- Health insurance
- Dental and vision plans
- Short and long term disability benefits
- 401(k) plan with match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources