Behavioral Health Medical Director-Psychiatrist

Company	Elevance Health
Location	Indianapolis, IN, USA, Tampa, FL, USA, Miami, FL, USA, Durham, NC, USA, Richmond, VA, USA, Winston-Salem, NC, USA, St. Louis, MO, USA, Mason, OH, USA, Metairie, LA, USA, Norfolk, VA, USA, Seven Hills, OH, USA, Columbus, OH, USA, Columbus, GA, USA, Portland, ME, USA, Waukesha, WI, USA, Cincinnati, OH, USA, Charleston, WV, USA, Overland Park, KS, USA
Salary	$Not Provided – $Not Provided
Type	Full-Time
Degrees	MD
Experience Level	Expert or higher

Requires MD or DO and Board certification approved by one of the following certifying boards is required, where 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 10 years of 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.

Conduct peer clinical and/or notes case reviews.
Supports the Medical Management staff ensuring timely and consistent responses to members and providers.
Conduct peer to peer clinical reviews with attending physicians or other ordering providers to discuss review determinations.
Provides guidance for clinical operational aspects of the program.
Identifies and develops opportunities for innovation to increase effectiveness and quality.
Serves as a resource and consultant to other areas of the company.
May interpret existing policies and develops new policies based on changes in the healthcare or medical arena.
May lead, develop, direct and implement clinical and non-clinical activities that impact health care quality cost and outcomes.
May serve on company committees.
May be required to represent Elevance Health to external entities and/or serve on external committees.

California medical license preferred.
Board Certified in Child & Adolescent psychiatry or Addiction Medicine is preferred.