Medical Director Associate - CarelonRx

Elevance Health | West Des Moines , IA 50265

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.

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.

Qualifications

• Requires MD or DO and board certification approved by one of the following certifying boards as 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.

Preferred Qualifications

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.

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 ~~~ 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 (~~~/) .

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