Behavioral Health Medical Director – Psychiatrist – California Medicaid (Part-Time)

About the role

This role enables associates to work virtually full-time, with the exception of required in-person meetings, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face collaboration.

Responsibilities

• Serves as a clinical advisor and thought leader through ongoing collaboration with health plan partners.
• 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.
• Makes clinical appeals 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.
• Develops and proposes 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.

Requirements

• 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).
• Active unrestricted medical license to practice medicine or a health profession in the state of California.
• Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Child and Adolescent, Addiction Psychiatry/Medicine board certification preferred.

Qualifications

• 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.

Benefits

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and a 401(k) + match. Additional benefits include medical, dental, vision, short and long term disability benefits, life insurance, wellness programs, and financial education resources. The health of our associates and communities is a top priority, requiring all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza.

Pay

The salary range for this specific position is $178,135 to $290,437.50. Location: California.

Schedule

This is a part-time position working 25 hours a week. The hours are flexible, but you will be expected to work over 5 days a week. No weekend or holiday expectations.

Behavioral Health Medical Director

The Behavioral Health Medical Director is responsible for overseeing California Medicaid behavioral health services, with a primary focus on conducting utilization management (UM) reviews across all levels of care.