Elevance Health
National Accounts Medical Director
Anticipated End Date:
2025-10-31
Position Title:
National Accounts Medical Director
Location:
This role enables associates to work virtually full-time, with the exception of required in-person training sessions. Hybrid virtual policy applies. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law.
Job Description The National Accounts Medical Director is responsible for serving as the Operational Medical Director for our care management models for our National Account clients. The medical director will be responsible for supporting the clinical vision and implementation to deliver an improvement in the health of the people we serve. The medical director supports product strategy/design through medical management that impacts health care quality, cost, and outcomes, and improving access to the health improvement tools offered to clients/members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance to account reporting regarding use of medical services by members, is involved in identifying and managing medical utilization trends, emerging trends and market changes that impact the client and members, and is responsible for proactively identifying and solutioning with account management, Sales RVP Medical Directors.
How You Will Make an Impact
Day to day clinical responsibilities mean that the medical director is directly involved in Utilization Management and Case Management.
Daily case reviews for both utilization and case management issues. (80/20 split)
Consistent adoption and implementation of all medical policies used for operational reviews.
Leading multidisciplinary rounds for case management / complex clinical management.
Peer-to-peer outreach for both utilization reviews and also for case management consultation with treating providers.
Clinical report reviews, trend management, benefit design consultation, and supporting overall clinical performance guarantee success.
The medical director will be responsible for supporting all state specific requirements that apply for each state where there is our business.
Minimum 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.
Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a U.S. military base, vessel or any embassy located in or outside of the U.S.
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, 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.
Preferred Qualifications
Indiana MD license or compact state multi-licensure is preferred but not exclusive.
Board certification preferably in a Primary Health Specialty, Family or Internal medicine or Surgery (surgical specialty).
Knowledge and experience with population or segment health management is a plus.
Knowledge of the health insurance industry and the National Accounts segment is preferred.
Salary & Benefits For candidates working in person or virtually in the below location(s), the salary range for this specific position is $250,236 to $411,102.
Locations:
Illinois, DC, Nevada.
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (all benefits are subject to eligibility requirements).
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Job Family & Level Job Level:
Director Equivalent
Job Family:
MED > Licensed Physician/Doctor/Dentist
Workshift 1st Shift (United States of America)
Additional Information Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Equal Employment Opportunity Statement Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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2025-10-31
Position Title:
National Accounts Medical Director
Location:
This role enables associates to work virtually full-time, with the exception of required in-person training sessions. Hybrid virtual policy applies. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law.
Job Description The National Accounts Medical Director is responsible for serving as the Operational Medical Director for our care management models for our National Account clients. The medical director will be responsible for supporting the clinical vision and implementation to deliver an improvement in the health of the people we serve. The medical director supports product strategy/design through medical management that impacts health care quality, cost, and outcomes, and improving access to the health improvement tools offered to clients/members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance to account reporting regarding use of medical services by members, is involved in identifying and managing medical utilization trends, emerging trends and market changes that impact the client and members, and is responsible for proactively identifying and solutioning with account management, Sales RVP Medical Directors.
How You Will Make an Impact
Day to day clinical responsibilities mean that the medical director is directly involved in Utilization Management and Case Management.
Daily case reviews for both utilization and case management issues. (80/20 split)
Consistent adoption and implementation of all medical policies used for operational reviews.
Leading multidisciplinary rounds for case management / complex clinical management.
Peer-to-peer outreach for both utilization reviews and also for case management consultation with treating providers.
Clinical report reviews, trend management, benefit design consultation, and supporting overall clinical performance guarantee success.
The medical director will be responsible for supporting all state specific requirements that apply for each state where there is our business.
Minimum 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.
Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a U.S. military base, vessel or any embassy located in or outside of the U.S.
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, 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.
Preferred Qualifications
Indiana MD license or compact state multi-licensure is preferred but not exclusive.
Board certification preferably in a Primary Health Specialty, Family or Internal medicine or Surgery (surgical specialty).
Knowledge and experience with population or segment health management is a plus.
Knowledge of the health insurance industry and the National Accounts segment is preferred.
Salary & Benefits For candidates working in person or virtually in the below location(s), the salary range for this specific position is $250,236 to $411,102.
Locations:
Illinois, DC, Nevada.
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (all benefits are subject to eligibility requirements).
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Job Family & Level Job Level:
Director Equivalent
Job Family:
MED > Licensed Physician/Doctor/Dentist
Workshift 1st Shift (United States of America)
Additional Information Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Equal Employment Opportunity Statement Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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