Job Closed

This listing is no longer active.

Optum logo
Optum

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

Medical Claims Review Medical Director - Hematology or Oncology - Remote

Medical DirectorMedical DirectorOtherRemoteSeniorTeam 160,000Since 2011Company Site

Location

Texas + 5 moreAll locations: Texas | Illinois | Colorado | California | Arizona | Minnesota

Posted

97 days ago

Salary

$248.5K - $373K / year

Seniority

Senior

Bachelor Degree9 yrs expEnglishExcel

Job Description

Medical Claims Review Medical Director - Hematology or Oncology - Remote

Optum

Requisition Number: 2328754 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations - Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements - Engage with requesting providers as needed in peer-to-peer discussions - Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews - Participate in daily clinical rounds as requested - Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy - Communicate and collaborate with other internal partners You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - M.D. or D.O. - Active unrestricted medical license and ability to obtain additional state medical licenses as needed - Board certification in Oncology or Hematology - 5+ years of clinical practice experience after completing residency training - Proven sound understanding of Evidence Based Medicine (EBM) - Demonstrated PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: - Texas or California License - Compact License - Experience in utilization review - Demonstrated data analysis and interpretation aptitude - Proven innovative problem-solving skills - Proven excellent presentation skills for both clinical and non-clinical audiences - Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Compensation for this specialty generally ranges from $248,500 - $373,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Benefits

  • 401(K), Dental insurance, Disability insurance, Employee stock purchase plan, Family medical leave, Flexible Spending Account (FSA), Generous parental leave, Generous PTO, Health insurance, Job training & conferences, Life insurance, Charitable contribution matching, Paid holidays, Paid sick days, Performance bonus, Tuition reimbursement, Vision insurance, Mental health benefits, Personal development training, Bereavement leave benefits

Related Categories

Related Job Pages

More Medical Director Jobs

Optum logo

Child and Adolescent Behavioral Medical Director - Remote

Optum

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

Medical Director97 days ago
OtherRemoteTeam 160,000Since 2011

Requisition Number: 2336776 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Behavioral Medical Director is responsible for overseeing and guiding the Utilization Management team. This individual will interact directly with Psychiatrists, Behavioral Health Providers, and other clinical professionals, such as Psychiatric Nurses, who consult on various complex clinical scenarios, processes and programs. The Behavioral Medical Director is part of a team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on system improvement opportunities. They are responsible for timely peer reviews, appeals and consultations with providers and other community-based clinicians, including general practitioners, and will work collaboratively with utilization management, care management, quality, account management, and operations teams. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Ensuring delivery of cost-effective quality care that incorporates recovery, resiliency, and person-centered services - Implementation of Level of Care guidelines and Utilization Management protocols - Provide clinical oversight and support to the clinical staff, oversee the management of services at all levels of care in the benefit plan - Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience The Behavioral Medical Director will support: - Clinical review and oversight of behavioral health cases in collaboration with multidisciplinary team members - Peer-to-peer consultations - Compliance with state regulations and licensure - Quality assurance and audit readiness for accreditation You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - Doctor of Medicine or Osteopathy - Current license to practice as a physician without restrictions and willing to maintain necessary credentials to retain the position - Board certified in Psychiatry - Board certified in Child and Adolescent Psychiatry - Experience working in a multidisciplinary clinical team - Knowledge of post-discharge care planning such as home care, discharge planning, care management, and disease management - Computer and typing proficiency, data analysis, and organizational skills - Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals - Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation, and recovery - Demonstrated competence in use of electronic health records as well as associated technology and applications - Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues - Participate in rotational holiday and call coverage Preferred Qualifications: - 3+ years of experience as a practicing psychiatrist post residency - Managed care experience to include familiarity with Utilization Management guidelines - Familiar with behavioral services within the NY, NJ, CT Tri-State area; to include active licensure - Understanding of Medical Behavioral Integration and Whole Person Care concepts and application - Based in Eastern time zone - Willing to obtain additional state licensure, with support *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $268,000 to $414,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Florida + 10 moreAll locations: Florida | Georgia | Virginia | New York | Maryland | Massachusetts | Connecticut | North Carolina | South Carolina | Rhode Island | Pennsylvania
$268K - $414K / year
Job Closed
Optum logo

Medical Claims Review Medical Director - Sleep or Pulmonology - Remote

Optum

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

Medical Director97 days ago
OtherRemoteTeam 160,000Since 2011

Requisition Number: 2336685 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations - Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements - Engage with requesting providers as needed in peer-to-peer discussions - Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews - Participate in daily clinical rounds as requested - Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy - Communicate and collaborate with other internal partners You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - M.D. or D.O - Active unrestricted medical license and ability to obtain additional state medical licenses as needed - Board certification in Internal Medicine - 5+ years of clinical practice experience treating Sleep and Pulmonology disorders, after completing residency training - Proven sound understanding of Evidence Based Medicine (EBM) - Demonstrated PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: - Texas or California License - Compact License - Experience in utilization review - Proven innovative problem-solving skills - Proven excellent presentation skills for both clinical and non-clinical audiences - Demonstrated data analysis and interpretation aptitude - Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills - Reside in PST, or MST *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $248,500 - $373,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Texas + 5 moreAll locations: Texas | Illinois | Colorado | California | Arizona | Minnesota
$248.5K - $373K / year
Job Closed
Optum logo

Medical Director - Post-Acute Care Management - Care Transitions - Remote

Optum

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

Medical Director97 days ago
OtherRemoteTeam 160,000Since 2011

Requisition Number: 2333791 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Why Care Transitions? At Care Transitions, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. Care Transitions is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. We are currently looking for Medical Directors that can work daytime in any of the continental time zones in the US. Primary Responsibilities: - Provide daily utilization oversight and external communication with network physicians and hospitals - Daily UM reviews - authorizations and denial reviews - Conduct peer to peer conversations for the clinical case reviews, as neededConduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care - Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions' services - Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers - Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders - Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers - Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals - Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees - Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting - Regularly meet with Care Transitions' leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues - Provide input on local needs for Analytics Team and Client Services Team to better enhance Care Transitions' products and services - Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME - Participate on the Medical Advisory Board - Providing intermittent, scheduled weekend and evening coverage - Perform other duties and responsibilities as required, assigned, or requested You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - Board certification as an MD, DO, MBBS with a current unrestricted license to practice and willing to maintain necessary credentials to retain the position - Current, unrestricted medical license and the ability to obtain licensure in multiple states - 3+ years of post-residency patient care, preferably in inpatient or post-acute setting Preferred Qualifications: - Licensure in multiple states - Willing to obtain additional state licenses, with Optum's support - Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care - Demonstrated ability to work within a team environment while completing multiple tasks simultaneously - Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision - Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals - Demonstrated competence in use of electronic health records as well as associated technology and applications - Proven excellent organizational, analytical, verbal and written communication skills - Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues - Proven highest level of ethics and integrity - Proven highly motivated, flexible and adaptable to working in a fast-paced, dynamic environment *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $248,500 - $373,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Texas + 7 moreAll locations: Texas | Georgia | Colorado | Arizona | Washington | Nevada | California | Missouri
$248.5K - $373K / year
Job Closed
OtherRemoteTeam 10,001+H1B Sponsor

Anticipated End Date: 2026-03-20 Position Title: Manager, Nurse Practitioners - CareBridge Job Description: Manager, Nurse Practitioner Candidates MUST be able to start on one of the following training dates: 4/6, 4/20, 5/4, 5/18 Virtual - This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), 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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work Shift(s): - After Training: 8 AM - 5 PM EST, Monday-Friday - During Training: 9 AM- 6 PM EST - Rotating on Call The Manager Nurse Practitioner is responsible for ensuring effective and efficient treatment of patients while managing multiple nurse practitioners. How you will make an impact: - Oversees and manages Clinical Programs operations. - Manages patient caseloads. - Provides resources and direction to Nurse Practitioners. - Performs physical examinations, preventive health measures, and follow up visits within prescribed guidelines and physician instructions. - Orders, interprets and evaluates diagnostic tests to identify and assess patient's clinical problems and health care needs. - Discusses case with physician and formulates and documents care plan. - Prescribes medication or other forms of treatment. - Reviews documentation to ensure compliance with best practices, protocols, and quality measures. - Hires, trains, coaches, counsels, and evaluates performance of direct reports. Minimum Requirements: - Requires an MS in Nursing and minimum of 5 years of nursing experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license and NP license in applicable state required. - For Carelon Health business unit, satisfactory completion of a Tuberculosis test is a requirement for this position. Preferred Skills, Capabilities and Experiences: - Compact nursing license highly preferred. - At least 3 years of management experience, preferably in a fast-paced environment. - Excellence in data management and advanced computer skills including Microsoft suite, electronic medical records, etc. - Expert communication skills, oral and written. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $128,560-$221,766. Location(s): Iselin, NJ, Woburn, MA 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 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. Job Level: Manager Workshift: Job Family: MED > Licensed Nurse 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. 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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

United States
$128K - $221K / year
Job Closed