Behavioral Health Medical Director – Psychiatrist

Elevance Health

Behavioral Health Medical Director overseeing administrative duties for Pennsylvania Medicaid. Supporting clinicians and developing medical policies to enhance healthcare quality and outcomes.

Posted 5/15/2026full-timeSeven Fields • Pennsylvania • 🇺🇸 United StatesLeadWebsite

About the role

Key responsibilities & impact

Supports clinicians to ensure timely and consistent responses to members and providers.
Provides guidance for clinical operational aspects of a program.
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 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.
Travel to an office for in-person meetings when necessary.

Requirements

What you’ll need

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 in Pennsylvania.
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.
Ability to obtain a Pennsylvania and potentially other medical licenses upon hire.
Child and Adolescent board certification preferred.
Utilization management experience preferred.

Benefits

Comp & perks

merit increases
paid holidays
Paid Time Off
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
financial education resources

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

clinical reviewspeer-to-peer clinical reviewsmedical policy interpretationclinical guidelines interpretationhealth care quality improvementutilization management

Soft Skills

leadershipconsultationcommunicationinnovationorganizational skills

Certifications

MDDOBoard certificationAmerican Board of Medical Specialties (ABMS)American Osteopathic Association (AOA)active unrestricted medical license