Behavioral Health Medical Director – Child & Adolescent Psychiatry

Anticipated End Date

If you want to know about the requirements for this role, read on for all the relevant information.

2024-09-15

Position Title

Behavioral Health Medical Director Child & Adolescent Psychiatry

Job Description

Wellpoint, formerly Amerigroup, is a proud member of Elevance Health’s family of brands, offering Medicaid and Medicare plans in several states.

We also provide administrative services to Medicaid plans in partnership with blue cross blue shield plans.

This is an individual contributor role. This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our Elevance Health office locations.

The successful candidate will be a Board Certified Child & Adolescent Psychiatrist who will be responsible for appeals reviews within our Medicaid and Medicare programs.

The Behavioral Health Medical Director is responsible for the administration of behavioral health medical services, to ensure the appropriate and most cost effective medical care is received.

May be responsible for developing and implementing programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical / strategic advisor to enhance clinical operations.

May identify cost of care opportunities. May serve as a resource to staff including Medical Director Associates.

How You Will Make An Impact

• Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations, and patients office visits with providers and external physicians.
• May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.
• Serves as a resource and consultant to 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.

• Works independently with oversight from immediate manager.
• May be responsible for an entire clinical program and / or independently performs clinical reviews.
• The Medical Director typically has program management responsibilities including clinical policy development, program development / implementation, and overseeing clinical / non-clinical activities.
• Supports clinicians to ensure timely and consistent responses to members and providers.
• Provides guidance for clinical operational aspects of a program.

Minimum Requirements

• Requires MD or DO and Board certification approved by American Board of Psychiatry and Neurology in Child & Adolescent Psychiatry.
• 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.
• Minimum of 10 years of child & adolescent psychiatry clinical experience; or any combination of education and experience, which would provide 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 filing a role required by a State agency.
• For URAC accredited areas, the following professional competencies apply : Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
• If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a sensitive position’ work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions.

Salary Information

For candidates working in person or remotely in the below locations, the salary range for this specific position is $229,120 - $412,416.

Locations : California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ.

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

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.

Who We Are

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.

COVID-19 Vaccination Requirement

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19.

Equal Opportunity Employment

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.

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