Associate Medical Director
Elevance Health

Description

The Associate Medical Director is responsible for providing day-to-day guidance, support, and leadership for clinical and/or quality activities under the guidance of a Medical Director. Also responsible for supporting one or more Medical Directors in ensuring clinical integrity of broad and significant clinical programs.

Location: Must be licensed and reside in Connecticut

How you will make an impact:

• Provides clinical guidance for programs in the various fields of psychiatry, including general adult, addiction, and child and adolescent psychiatry.
  
• Supports clinicians to ensure timely and consistent review of requests for service authorization and responses to members and providers.
  
• Conducts peer-to-peer clinical reviews with attending physicians or other ordering providers to discuss level-of-care and medical necessity determinations.
  
• Conducts peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations.
  
• Conducts, on a limited basis, chart reviews for retrospective reviews, or second level appeal.
  
• Assists in evaluating the appropriateness of criteria used in clinical reviews, medical technology assessments, setting and implementing QI initiatives, and practitioner/provider credentialing.
  
• Under direction, may be responsible for the administration of medical services for company health plans including developing medical policies.
  
• Serves as a resource and consultant to other areas of the company. Interpret existing medical policy.
  
• May be required to represent the company to external entities and/or serve on internal and/or external committees.
  

Minimum Requirements:

• Requires MD or DO degrees and Board certification in general Psychiatry approved by one of the following certifying boards: American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
  
• Must possess an active unrestricted medical license to practice medicine in the state of Connecticut. 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 Skills, Capabilities, and Experiences:

• Demonstrated clinical experience in the field of addiction psychiatry or treatment of substance use disorders; certification in addiction psychiatry/medicine by ABPN, ASAM, or ABAM is preferred, but not required.
  

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

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. If you are not vaccinated, your offer will be rescinded unless you provide - and Elevance Health approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World's Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 ability@icareerhelp.com for assistance.

This job has expired.