Medical Director – Medicaid
Humana
Behavioral Health Medical Director, Psychiatrist
Elevance Health
part-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteSalary
💰 $274,068 - $411,102 per year
Job Level
Lead
About the role
- Administer behavioral health medical services to ensure appropriate and cost-effective care
- Develop and implement programs to improve quality, cost, and outcomes
- Provide clinical consultation and serve as clinical/strategic advisor
- Conduct peer-to-peer clinical reviews and appeal case reviews with providers
- Serve as resource/consultant to other areas and represent company externally
- Interpret medical policies and clinical guidelines; develop new policies
- Lead, develop, direct, and implement clinical and non-clinical activities impacting quality, cost, and outcomes
- Identify and develop opportunities for innovation
Requirements
- MD or DO and Board certification (ABMS or AOA)
- Active unrestricted medical license to practice in New Jersey
- Located in a state or territory of the United States when conducting utilization review or appeals
- Minimum of 10 years of clinical experience (or equivalent combination of education and experience)
- For Health Solutions and Carelon organizations, minimum of 5 years providing health care
- SUD and addiction medicine experience strongly preferred
- Managed care experience strongly preferred
