Associate Medical Director - Interventional Pain

Elevance Health•Tampa, FL

1d•Remote

About The Position

The Clinical Operations Associate Medical Director is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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.

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.

Nice To Haves

Board certification in Pain Management strongly preferred.
3 years clinical experience post fellowship strongly preferred.

Responsibilities

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.