Description
Medical Director National
Radiation Oncology
AIM/Carelon Benefit Management
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.
Job Summary:
Responsible for serving as a Medical Director of the National Accounts business unit, leading the strategic implementation of improving the health of the people we serve, influencing product strategy and design and medical management approaches that impact health care quality, cost, and outcomes, and improving access to and usefulness of health improvement tools offered to National Account members. The Medical Director is responsible for ensuring the clinic integrity of the Radiation Oncology AIM solution, making sure the program improves the appropriateness of care, improves patient outcomes and reduces cost. The Radiation Oncology solution covers radiation therapy, including intensity modulated radiation therapy (IMRT), external beam radiation therapy (EBRT), proton beam therapy, stereotactic body radiation therapy (SBRT), stereotactic radiosurgery (SRS), brachytherapy and therapeutic radiopharmaceuticals. The Medical Director leads the clinical development of the solution, including the overall strategic approach, program design, and clinical underpinnings (clinical evidenced based guidelines that are the foundation for the interventions which will be made by AIM on behalf of its clients.) The Medical Director contributes to program innovation and evolution over time to increase efficiency and impact.
How you will make an impact:
- Monitors competitor products and internal medical management capabilities and responds with recommendations for improvement in company models.
- Contributes to development of Medical Management and Quality Management strategies.
- Responsible for consistent adoption and implementation of all medical policies.
- Provides clinical leadership for Utilization Management, Case Management, Disease Management, and Quality Management of National Accounts in cooperation with Regional Health Care Management (HCM) team and Chief Medical Officer.
- Provides clinical expertise in sales planning and participates in the acquisition and retention of National Accounts.
- Collaborates with HCM leaders to refine and improve provider and medical management services to meet the needs of National Accounts.
- Assures the clinical relevance of account reporting regarding use of medical services by National Accounts members.
- Communicates medical management trends and recommends company medical management responses to National Accounts.
- Contributes to efforts to establish effective physician and hospital quality and cost profiling and education.
- Contributes to improved provider relationships and national associations and societies (i.e., AMA, Coalition of Specialty Societies).
- Represents company at nationally recognized speaking engagements to promote health programs.
Minimum Requirements:
- Requires an MD and minimum of 12 years of healthcare experience; or any combination of education and experience, which would provide an equivalent background.
- Requires current unrestricted medical licensure in applicable state(s).
- Board certification required if applicable to the duties being performed.
- Requires experience with population or segment health management and the education and coaching of members on wellness, prevention, and healthy lifestyles.
Preferred Skills, Capabilities and Experiences:
- Board Certification in Radiation Oncology by ABRO.
- Experience in clinical coding.
- Experience with population or segment health management.
- Experience leading competitive product offerings in the healthcare industry and National Accounts expectations.
- Knowledge of leading competitive product offerings in the healthcare industry and marketplace standards and knowledge of National Accounts expectations strongly preferred.
- Extensive managed care knowledge strongly preferred.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $244,800 to $440,640.
Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY
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 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. A Fortune 20 company with a longstanding history in the healthcare industry, 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 in certain patient/member-facing roles 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.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.