Medical Director - Radiation Oncology

Anticipated End Date:

Position Title: Medical Director - Radiation Oncology

Job Description:

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit‑management leader in Illinois. Our platform delivers significant cost‑of‑care savings across an expanding set of clinical domains, including radiology, cardiology and oncology.

The Clinical Operations Medical Director is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers.

• Ensures timely completion of clinical case reviews for their board certified specialty.
• Makes physician to physician calls to gather medical appropriate information in order to make medical necessity determinations for services requested.
• 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 their supervisors attention, any case review decisions that require Medical Director review or policy interpretation.

• 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.
• Minimum of 1 year of experience with clinical case reviews for medical necessity. The minimum of 1 year of experience with clinical case reviews would be waived for the following specific specialties only;
  Cardiology, Oncology, and Interventional Pain specialties. Board certification in a medical specialty required.

• Board certified in Radiation Oncology strongly preferred

For candidates working in person or virtually in the below location(s), the salary
* range for this specific position is $225,036 to $352,236

California;
District of Columbia (Washington, DC), New Jersey, New York

Job Level: Non-Management Non-Exempt

Workshift: 1st Shift (United States of America)

Job Family: MED >
Licensed Physician/Doctor/Dentist

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 elevancehealthj 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.