LTSS Medical Director - Kansas Medicaid

LTSS Medical Director – Kansas Medicaid Location: Full‑time virtual with required in‑person training sessions. Candidates must live in Kansas or just over the border in Missouri. How you will make an impact Supports clinicians to ensure timely and consistent responses to members and providers. Provides guidance for clinical operational aspects of the program. Conducts peer‑to‑peer clinical reviews with attending physicians or other providers to discuss review determinations. May conduct peer‑to‑peer clinical appeal case reviews. Serves as a resource and consultant for other areas of the company. May represent the company to external entities and/or serve on internal and/or external committees; may chair company committees. Interprets medical policies and clinical guidelines; may develop and propose new medical policies. Leads, develops, directs, and implements clinical and non‑clinical activities that impact health care quality, cost and outcomes. Identifies and develops opportunities for innovation to increase effectiveness and quality. Minimum Requirements MD or DO with board certification required by ABMS or AOA. Active unrestricted medical license to practice medicine or a health profession. Must be located in the United States when conducting utilization review or appeals. Minimum of 10 years of clinical experience (or equivalent education/experience). For Health Solutions and Carelon organizations, minimum of 5 years of experience providing health care. Preferred Qualifications Ability to obtain a Kansas medical license. Board certification in any Primary Care Specialty with Geriatrics experience. Five years of experience directing health care services for frail elderly or individuals with physical, intellectual, and/or developmental disabilities. Job Level: Director Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Physician/Doctor/Dentist Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, 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. #J-18808-Ljbffr The Elevance Health Companies, Inc.