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Associate Medical Director- Psychiatry

  • Job Family: Medical and Clinical
  • Type: Full time
  • Date Posted:
  • Anticipated End Date:
  • Reference: JR105324

Location:

  • CT, ROCKY HILL

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Description

The Associate Medical Directo r 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. This is a hybrid role, 1-2 days a week in office requirement.

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 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.


 

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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 an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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 elevancehealthjobssupport@elevancehealth.comfor assistance.

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