Medical Director Associate - CarelonRx

About the role

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

Requirements

• Utilization management experience preferred.
• For candidates working in person or virtually in the below locations, the salary* range for this specific position is $231,504.00 to $396,864.00.
• Location(s): California, Nevada, Illinois, Washington state.
• 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:
• 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.

Benefits

Additional Information

Anticipated End Date: 2026-07-10 Position Title: Medical Director Associate - CarelonRx Job Description: Medical Director Associate - CarelonRx Location: 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. Alternate locations may be considered. CarelonRx delivers market-leading pharmacy benefit management and medication dispensing services to drive affordability and improve member outcomes. The Medical Director Associate- CarelonRx supports pharmacy prior authorization reviews to ensure turnaround time is met and we are in compliance with all Pharmacy Benefit Management regulatory requirements. How you will make an impact: May provide clinical guidance for pharmacy prior authorizations using CarelonRx clinical guidelines. Supports clinicians to ensure timely and consistent responses to members and providers. Conducts peer-to-peer prior authorization reviews for medications with attending physicians or other ordering providers to discuss review determinations. Will participate in a physician on-call weekend rotation for a 24x7 unit. Minimum 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. Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US. Minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.

Your Match

How well this role fits your profile.

Company Intel

What employees say

Worked at Elevance Health (Anthem)? Share your experience