• Responsible for providing clinical oversight and performing medical necessity reviews for home health and durable medical equipment (DME) prior authorization and other coverage requests. • Supports the provision of timely, evidence-based decisions aligned with payer policy, regulatory requirements, and best clinical practices. • Collaborate with utilization management, care coordination, and provider-network engagement teams to support high-quality, cost-effective care delivery in the home setting.

The job profile for this position is Medical Principal, which is a Band 5 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Associate Medical Director – Quality & Safety Organization: MDLIVE by Evernorth Location: Remote About the Role MDLIVE by Evernorth is seeking an experienced physician leader to join our Quality & Safety team as an Associate Medical Director (AMD). This role advances clinical excellence, patient safety, and physician engagement across our virtual care ecosystem. The AMD divides responsibilities between clinical practice (25%) and administrative leadership (75%), supporting both direct care and quality‑improvement initiatives. Key Responsibilities - Promote high standards of clinical quality, patient safety, and risk reduction. - Provide clinical consultation and support to MDLIVE physicians. - Lead or participate in patient‑safety programs and quality‑improvement initiatives. - Conduct chart reviews, evaluate clinical performance, and support remediation when needed. - Contribute to the development of clinical guidelines, policies, and care‑delivery protocols. - Support physician onboarding, education, and engagement efforts. - Maintain strong clinical performance metrics within ongoing practice. Qualifications - Board‑certified in Family Medicine, Internal Medicine, Emergency Medicine required - Minimum of 5 years of post‑residency clinical experience. - Minimum of 5 years of healthcare leadership or administrative experience. - Proven experience in patient safety, quality improvement, and risk management. - Strong analytical, communication, and problem‑solving abilities. - Proficiency with digital tools, virtual‑care platforms, and data‑driven decision‑making. Work Environment - Remote work environment. - Fast‑paced, collaborative, and innovative virtual‑care setting. - Compliance with all privacy and security standards for PHI/PII required. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 212,600 - 354,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan and long term incentive plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Anticipated End Date: 2026-04-24 Position Title: Specialist Medical Director - Cardiology Job Description: Clinical Operations Medical Director Specialist Carelon Medical Benefit Management Cardiology Specialty Virtual: 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. 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. 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. The Clinical Operations Medical Director is responsible for performing pre-authorizations and providing quality improvement solutions involving cardiovascular procedures and requests for oncologic treatment (medical or radiation) including future expansions. How you will make an impact: - Determines the medical necessity of requests using clinical criteria. - Performs physician-level case review of cardiovascular or oncologic utilization requests. - Conducts peer-to-peer consultation 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. - Provides education regarding applicable clinical criteria and discusses clinically appropriate interventional and non-interventional options. - Performs first level provider appeals for coverage decisions. - Provides support and education to internal clinical and non-clinical staff regarding the principles associated with appropriate diagnoses, treatments, and management related to these specialties. - Participates in physician team meetings. - Participates in groups that develop, revise and enhance clinical appropriateness guidelines. Minimum Requirements: - Requires MD and/or DO, completion of training in Cardiology, Oncology, or related board certification by either the American Board of Medical Specialties or the American Osteopathic Association Specialties. - Requires a current, valid, active and unrestricted medical license(s) as a Doctor of Medicine or Doctor of Osteopathic Medicine in appropriate state(s). - Requires a minimum of 5 years of clinical experience. Preferred Skills, Capabilities, and Experiences: - Experience with utilization management, especially with CMS guidelines preferred. - Board certification in Cardiology strongly preferred. Job Level: Director Equivalent Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Physician/Doctor/Dentist 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.

• Drive growth of a therapeutic area portfolio through medical and clinical development expertise and by providing medical oversight of awarded clinical trials • Participate in the lifecycle of CTI’s work from early engagement to clinical consulting to RFP and bid defenses to clinical trial execution and delivery • Accountable for medical oversight and management of awarded studies, including protocol review, eligibility discussions, oversight of medical issues, training of internal and site teams, safety review, and medical support of regulatory issues • Early engagement business development activities, including providing advice and recommendations on protocols and clinical development plans, assessing key needs of sponsors, and applying innovations • Responsible for working with a broad range of sponsors, creatively assessing opportunities, and developing strategies for trials and innovations for the execution of studies • Use clinical, scientific, and operational knowledge to harness data and clinical trial resources to develop innovative, data-driven, and patient-centered solutions for clinical development projects, studies, and trials, addressing the specific needs and challenges of each customer • Provide clinical and scientific expertise to all CTI departments as requested and collaborate closely with teams to develop integrated strategies for clinical trials and studies • Partner with the regulatory team on clinical development plans, target product profiles, regulatory submissions, interactions with health authorities, and protocol development • In partnership with Sales, Operations, and other functions, responsible for award of strategic and tactical new business to achieve annual Gross New Business targets. Along with other key experts, responsible for leading teams in developing focused proposals • Provide scientific, clinical, and operational advice to internal stakeholders developing proposals: this may include, but is not limited to, providing the strategy to protocol design/clinical development plan, mining data to address important clinical questions relevant to the study, reviewing the protocol for scientific/regulatory soundness and feasibility, identification of target site and principal investigator profiles, understanding the standard of care and competitive landscape, informing strategies for site and country selection and patient recruitment • Support preparation of customer and bid defense meetings, e.g., training and preparation of the assigned project team; provide specific content; ensure presentation focus and content effectively conveys therapeutic area strategy • Attends and presents at customer meeting, or bid defense or partnership meetings, as required • Responsible for staying current on industry pipeline and scientific and business landscape; does due diligence research of the therapeutic landscape; educates and informs CTI clinical and business teams about cutting-edge therapeutic developments • Drive thought leadership activities including presentations, publications, and interactions with the medical scientific community to connect key areas of growth and innovation that CTI is focused on. which include cell and gene therapy and rare disease, and groundbreaking strategies to optimize the execution of clinical trials, using data and patient-centered approaches • Administration and management of the Medical Affairs department, including direct reports, review of finances, and shaping the vision and strategy for the medical department