Top 95 Wellpoint Jobs

Associate Medical Director - Outpatient Rehab
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Patient Safety DRG Clinical Validation Auditor
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Simply Field Sales & Service Rep
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National Accounts Strategic Underwriter
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DRG Clinical Validation Lead
Elevance Health —Indianapolis, IN
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- 7 years
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Regional Account Liaison - BioPlus Specialty Infusion- Ohio
Elevance Health —Columbus, OH
- $95,040 - $142,560 a year
- 6 years
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14d
SOC Shift Lead - Information Security
Elevance Health —Atlanta, GA
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LTSS Service Coordinator - Clinician
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AFC Field Sales & Service Rep
Elevance Health —Port Saint Lucie, FL
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LTSS Service Coordinator - RN Clinician
Elevance Health —Lubbock, TX
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Financial Consultant
Elevance Health —San Juan, PR
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Patient Safety DRG Coding Auditor Principal
Elevance Health —Indianapolis, IN
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Clinical Provider Auditor Lead - Maryland Behavioral Health
Elevance Health —Hanover, MD
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Mcare Inside Sales & Ret Agent
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Elevance Health —Cerritos, CA
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Hemophilia Account Executive- Paragon Healthcare - Ohio, Indiana, Illinois
Elevance Health —Mason, OH
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Senior Manager, Subrogation & Recovery Operations - Carelon
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9d

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Associate Medical Director - Outpatient Rehab

Elevance Health -
Costa Mesa, CA

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Job Details

Full-time
$188,051 - $294,910 a year
10 days ago

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

BC/BE
Medical License

Full Job Description

Clinical Operations Associate Medical Director

Carelon Medical Benefits Management

Outpatient Rehab Utilization Management Review

Preferred Shift: 8am-5pm Pacific Time

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.

Carelon, a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center-connecting physical, behavioral, social, and pharmacy services, along with clinical expertise, research, operations, and advanced technology to help care work better, together.

Among us are specialty-care physicians, nurse practitioners, pharmacists, engineers, data scientists, and other dedicated and caring health professionals. While our roles may differ, our purpose is shared: to make a positive impact on whole health.

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

How you will make an impact:

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 medical policies when making medical necessity decisions.
Brings to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation.

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.

Preferred Skills, Capabilities, and Experiences:

PM&R Board Certification preferred.
Expereince in Inpatient or outpatient rehab.
Expereince with Microsoft Office Suite.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $188,051 to $294,910.

Locations:

California, Illinois

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

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.

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 [email protected] 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

Apply Now

Refine Your Search

Wellpoint jobs

Associate Medical Director - Outpatient Rehab

Plan Performance Medical Director- Wisconsin and Missouri Markets

Patient Safety DRG Clinical Validation Auditor

Business Change Advisor Sr

Patient Safety DRG Clinical Validation Auditor

Simply Field Sales & Service Rep

National Accounts Strategic Underwriter

DRG Clinical Validation Lead

Regional Account Liaison - BioPlus Specialty Infusion- Ohio

SOC Shift Lead - Information Security

LTSS Service Coordinator - Clinician

AFC Field Sales & Service Rep

LTSS Service Coordinator - RN Clinician

Financial Consultant

Patient Safety DRG Coding Auditor Principal

Clinical Provider Auditor Lead - Maryland Behavioral Health

Mcare Inside Sales & Ret Agent

Epic Interface Analyst

Hemophilia Account Executive- Paragon Healthcare - Ohio, Indiana, Illinois

Senior Manager, Subrogation & Recovery Operations - Carelon

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