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Associate Medical Director - Neurosurgery - AIM Specialty Health

Location:

  • IL, Deerfield
  • Nevada, Las Vegas
  • California, Los Angeles
  • Virginia, Richmond
  • Texas, Houston
  • Ohio, Mason
  • Georgia, Atlanta
  • Missouri, St. Louis
  • Kentucky, Louisville
  • Texas, Dallas
  • Tennessee, Nashville
  • Florida, Miami
  • Indiana, Indianapolis
  • Florida, Tampa
  • Virginia, Virginia Beach

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Description

Associate Medical Director – Neurosurgery/Ortho Spine Surgery

Location: Remote position, can work/live anywhere.

Build the Possibilities. Make an extraordinary impact.

The Associate Medical Director - Neurosurgery is responsible for performing pre-authorizations and providing quality improvement solutions for musculoskeletal procedures involving the spine and/or joints, and high-tech diagnostic imaging.

How you will make an impact:

  • Determines the medical necessity of requests using clinical criteria.

  • Performs physician-level case review of musculoskeletal utilization requests.

  • Conducts peer-to-peer consultation with ordering physicians, physician assistants and advanced practice nurses regarding established guidelines and accepted standards of care as it relates to treatments, surgical procedures, imaging, and appropriate sites of service.

  • Provides education regarding applicable clinical criteria and discusses clinically appropriate alternative surgical and non-surgical treatments.

  • Performs first level provider appeals of coverage decisions.

  • Provides support and education to internal clinical and non-clinical staff regarding the principles associated with appropriate musculoskeletal diagnoses, treatments, and management.

  • Participates in physician team meetings.

  • Participates in groups that develop, revise, and enhance clinical appropriateness guidelines.

Minimum Requirements:

  • Requires MD or DO and Board certification by the American Board of Neurologic Surgery or American Osteopathic Board of Neurosurgery.

  • Additionally, American Board of Orthopedic Surgery with completion of fellowship training in Spine Surgery or American Osteopathic Board of Orthopedic Surgery with completion of fellowship training in Spine Surgery also meets the Board certification requirements for this position.

  • Current unrestricted medical license(s) as a Doctor of Medicine or Doctor of Osteopathic Medicine in appropriate state(s) required.

  • Experience performing standard neurosurgical spine procedures independently.

Preferred Skills, Capabilities and Experiences:

  • Strong oral communication and interpersonal skills

  • Computer literacy with the ability to learn new applications

  • Strong analytical skills

  • Ability to multi-task

  • Ability to work both independently and in a team environment

  • Ability to work in a dynamic, fast-paced environment

  • Minimum of 5 years of clinical practice experience past fellowship training preferred.

  • Extensive spine surgery experience preferred. Experience with utilization management, especially with CMS guidelines preferred.


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. 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 ability@icareerhelp.com for assistance.

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