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Associate Medical Director- Orthopedic Spine Surgery

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Elevance Health

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Location:
United States of America , Costa Mesa ▼

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Category:
Health and Beauty

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Contract Type:
Not provided

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Salary:

178.78 - 279.84 USD / Hour
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Job Description:

The Clinical Operations Associate Medical Director is responsible for performing pre-authorizations and providing quality improvement solutions for musculoskeletal procedures involving the spine and/or joints, and high-tech diagnostic imaging.

Job Responsibility:

  • Performing pre-authorizations and providing quality improvement solutions for musculoskeletal procedures involving the spine and/or joints, and high-tech diagnostic imaging
  • Determines the medical necessity of requests using clinical criteria
  • Performs physician-level case review of musculoskeletal utilization requests
  • Conducts peer-to-peer consultation with ordering physicians, physician assistants and advanced practice nurses regarding established guidelines and accepted standards of care
  • Provides education regarding applicable clinical criteria and discusses clinically appropriate alternative surgical and non-surgical treatments
  • Performs first level provider appeals of coverage decisions
  • Provides support and education to internal clinical and non-clinical staff
  • Participates in physician team meetings
  • Participates in groups that develop, revise and enhance clinical appropriateness guidelines

Requirements:

  • MD/DO and Board certification by the American Board of Neurologic Surgery or American Osteopathic Board of Neurosurgery
  • American Board of Orthopedic Surgery with completion of fellowship training in Spine Surgery or American Osteopathic Board of Orthopedic Surgery with completion of fellowship training in Spine Surgery
  • Current unrestricted medical license(s) as a Doctor of Medicine or Doctor of Osteopathic Medicine in appropriate state(s)
  • Experience performing standard neurosurgical spine procedures independently

Nice to have:

  • Minimum of 3 years of clinical practice experience past fellowship training
  • Extensive spine surgery experience
  • Experience with utilization management, especially with CMS guidelines
What we offer:
  • comprehensive benefits package
  • incentive and recognition programs
  • equity stock purchase
  • 401k contribution
  • merit increases
  • paid holidays
  • Paid Time Off
  • incentive bonus programs
  • medical, dental, vision, short and long term disability benefits
  • 401(k) +match
  • stock purchase plan
  • life insurance
  • wellness programs
  • financial education resources

Additional Information:

Job Posted:
March 21, 2026

Expiration:
April 03, 2026

Employment Type:
Fulltime
Work Type:
Hybrid work
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