Appeals Medical Director – Oncology 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. Role Overview: The Appeals Medical Director for Oncology is responsible for the appeal reviews of physical health medical services to ensure the appropriate, cost‑effective medical care is received. The role may involve developing and implementing programs to improve quality, cost, and outcomes; providing clinical consultation; and acting as a clinical/strategic advisor to enhance clinical operations. Opportunities to identify cost‑of‑care improvements are also included. How you make an impact Appeal Reviews. Supports clinicians to ensure timely and consistent responses to members and providers. Provides guidance for clinical operational aspects of a program. May conduct peer‑to‑peer clinical case reviews with attending physicians or other ordering providers to discuss review determinations. Serves as a resource and consultant for other areas of the company. May be required to 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 based on changes in healthcare. 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 approved by one of the following certifying boards—American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). Where applicable to duties performed, board certification is required. Active unrestricted medical license to practice medicine or a health profession. Unless expressly allowed by state or federal law, 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 U.S. military base, vessel or any embassy located in or outside of the U.S. Minimum of 10 years of clinical experience; or any combination of education and experience that provides an equivalent background. For Health Solutions and Carelon organizations (including behavioral health) only, minimum of 5 years of experience providing health care is required. Additional experience may be required by state contracts or regulations if the Medical Director is filling a role required by a state agency. Preferred Qualifications Board certification in Oncology or Hematology and Oncology—strongly preferred. Utilization Management or Appeals experience preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $247,840.00 to $446,112.00. Location(s): California, Columbus, Ohio, District of Columbia, Illinois, Maryland, Massachusetts, New Jersey, New York In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non‑discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. 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. 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. #J-18808-Ljbffr