Medical Director

Elevance Health

. Administer medical services to ensure members receive appropriate, cost-effective care .

Posted 10/8/2026full-timeUnited StatesLead💰 $247,840 - $427,524 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in clinical consultation, utilization management, and program development to enhance healthcare quality and cost-effectiveness. Holds a medical degree and board certification, with extensive experience in clinical settings and health plan operations.

Highest-signal resume keywords

MD/DOBoard CertificationUtilization ManagementClinical Consultation10+ Years Clinical Experience

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Clinical ReviewCost-Effectiveness AnalysisProgram DevelopmentQuality ImprovementClinical Guidelines Interpretation

Soft Skills

Independent WorkStrategic AdvisingResource ConsultationCommunication with Physicians

Certifications & Qualifications

Active Unrestricted Medical LicenseCOVID-19 VaccinationInfluenza Vaccination

Industry Keywords

Healthcare QualityCost ManagementUtilization ReviewHealth Plan OperationsClinical Outcomes

About the role

Key responsibilities & impact

Administer medical services to ensure members receive appropriate, cost-effective care
Develop and implement programs to improve quality, cost, and outcomes
Provide clinical consultation and serve as a clinical and strategic advisor
Identify cost-of-care opportunities that increase value for clients and members
Work independently with oversight from the immediate manager
Perform utilization management and support care management nursing staff for national clients
Provide guidance on clinical operational aspects for clients
Conduct peer-to-peer clinical reviews with attending physicians
Complete two two-week blocks of primary/back-up call per year during non-business hours when required
Serve as a resource and consultant for other company areas
Represent the company to external clients and serve on internal or external committees
Interpret medical policies and clinical guidelines
Direct and implement clinical activities affecting healthcare quality, cost, and outcomes
Identify and develop innovation opportunities to increase effectiveness and quality

Requirements

What you’ll need

MD/DO required
Board certification approved by ABMS or AOA, where applicable to duties performed
Active unrestricted medical license to practice medicine or a health profession
Must be located in a state or territory of the United States when conducting utilization review or appeals consideration, unless expressly allowed by law or regulation
Cannot be located on a US military base, vessel, or embassy located in or outside the US when conducting utilization review or appeals consideration
Minimum of 10 years of clinical experience
Prior experience within a health plan or involvement with hospital-based utilization review activities preferred
Must become vaccinated against COVID-19 and Influenza for certain patient/member-facing roles, unless an acceptable explanation is provided

Benefits

Comp & perks

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
401(k) with match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Virtual full-time work, except for required in-person training sessions
Professional and personal growth opportunities