Solution Medical Director for Post Acute Services

Location: Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate must live within 50 miles of an Elevance Health Pulse Point location.

The Solution Medical Director for Post Acute Services will be responsible for serving as a Medical Director of the Post Acute Care Services 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 Post Acute Care Services members.

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 Post Acute Care Services 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 Post Acute Care Services.

• Collaborates with HCM leaders to refine and improve provider and medical management services to meet the needs of Post Acute Care Services.

• Assures the clinical relevance of account reporting regarding use of medical services by Post Acute Care Services members.

• Communicates medical management trends and recommends company medical management responses to Post Acute Care Services.

• 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 Qualifications:

• Knowledge of leading competitive product offerings in the healthcare industry and marketplace standards and knowledge of Post Acute Care Services expectations strongly preferred.

• Extensive managed care knowledge strongly preferred.

• PM&R Board Certification strongly preferred.

• Clinical and leadership experience within a care delivery or payor system setting preferred.

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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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 elevancehealthjobssupport@elevancehealth.com for 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.