Associate Medical Director - Cardiology
Company: Elevance Health
Location: Sacramento
Posted on: May 25, 2023
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Job Description:
Associate Medical Director - Cardiology
Job Family: Medical and Clinical
Type: Full time
Date Posted:Apr 27, 2023
Req #: JR64318
Location:
CA, CERRITOS
IL, DEERFIELD
National +50 Miles away from nearest PulsePoint, National +50 Miles
away from nearest PulsePoint
Description
Associate Clinical Operations Medical Director
Cardiology Benefit Management
AIM Carelon Benefit Management
Location: This position will work a hybrid model with going into
the office 0-3 times per month if the candidate lives within 50
miles of an Elevance Health office.
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.
About this position:
AIM is currently seeking a Board-Certified Cardiologist to
participate in pre-authorization and quality improvement solutions
for echocardiography, vascular Doppler ultrasound, high-tech
diagnostic imaging (cardiac and non-cardiac) and cardiac procedures
such as coronary angiography, percutaneous coronary interventions,
and implanted cardiac devices. Physician Advisors determine the
medical necessity of requests using clinical appropriateness
guidelines and health plan medical policy.
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 including: echocardiography, vascular Doppler
ultrasound, high-tech diagnostic imaging (cardiac and non-cardiac)
and cardiac procedures (coronary angiography, percutaneous coronary
interventions, and implanted cardiac devices).
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.
Conduct peer-to-peer consultations with ordering physicians,
physician assistants and advanced practice nurses regarding
established guidelines and accepted standards of care as it relates
to treatments, procedures, imaging, and appropriate sites of
service.
Discuss clinically appropriate alternative treatments, imaging
studies and sites of care with ordering providers when consistent
with applicable clinical criteria.
Provide education regarding applicable clinical criteria.
Demonstrate and maintain knowledge of applicable ICD-10, HCPCS and
CPT coding guidelines as it relates to cardiology services and
procedures.
Minimum Requirements:
Preferred Skills, Capabilities and Experiences:
Cardiovascular Disease, Interventional Cariology or Clinical
Cardiac Electrophysiology by the American Board of Internal
Medicine strongly preferred.
3-5 years of clinical practice experience past fellowship training
is desirable.
For candidates working in person or remotely in the below
locations, the salary* range for this specific position is $158,725
to $285,692.
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 .
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.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
Please use the links below to review statements of protection from
discrimination under Federal law for job applicants and
employees.
EEO Policy Statement
Know Your Rights
Pay Transparency
Privacy Notice for California Residents
Elevance Health, Inc. is anE-verify Employer
(https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)
Need Assistance?
Email us (elevancehealth@icareerhelp.com) or call
1-877-204-7664
Keywords: Elevance Health, Sacramento , Associate Medical Director - Cardiology, Executive , Sacramento, California
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