Plan Medical Director

Plan Performance Medical Director at Elevance Health

Apply for this full‑time virtual role. The position initially takes place in a hybrid environment, with required in‑person training sessions and flexible scheduling.

USD $–$ per year.

The Plan Performance Medical Director oversees medical services for 17‑state ACA plans.

Key responsibilities include:

• Support the Medical Management staff to ensure timely responses to members and providers.
• Provide guidance for clinical operational aspects of the program.
• Conduct peer‑to‑peer clinical reviews with attending physicians or other providers regarding determinations and patient visits.
• Lead and develop clinical and non‑clinical activities that increase efficiency and quality.
• Develop new policies based on changes in the healthcare or medical arena.
• Identify and implement innovative opportunities.
• Share best practices across regions with other medical directors.
• Chair or serve on company and external committees as required.

• MD or DO with board certification from the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
• Active unrestricted medical license; must reside in the U.S. unless exempt by law. Minimum 10 years of clinical experience or equivalent education/experience.
• Strong oral, written, and interpersonal communication skills; problem‑solving, facilitation, and analytical capabilities.
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Preferred Skills, Capabilities and Experience
• Experience in clinical finance data, medical cost, and trend analysis.
• Strong presentation and writing abilities.
• Proficiency in Excel and PowerPoint.
Benefits

Comprehensive benefitsוכה anitation including medical, dental, vision, disability, 401(k) with company match, equity stock purchase, andMas incentive and recognition programs (subject to eligibility).

Equal Employment Opportunity Statement

Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by applicable law. Applicants requiring accommodation to participate in the job application process may contact elevancehealthj for assistance.