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Medical Director Associate Behavioral Health – New York Residency and License Required

Location:

  • NY, Latham
  • NY, NEW YORK

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Description

For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Medical Director Associate Behavioral Health – New York Residency and License Required

Responsible for providing day-to-day guidance, support, and leadership for clinical and/or quality activities under the guidance of a Medical Director. May be responsible for supporting one or more Medical Directors in ensuring clinical integrity of broad and significant clinical programs. May perform clinical review. Primary duties may include, but are not limited to:

  • May provide clinical guidance for programs.

  • Supports clinicians to ensure timely and consistent responses to members and providers.

  • Conducts peer-to-peer clinical reviews with attending physicians or other ordering 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.

  • May participate in a physician on-call rotation for a 24x7 unit.

  • May assist in the practitioner appeal reviews, appropriateness criteria 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 medical policies.

  • Serves as a resource and consultant to other areas of the company.

  • May interpret existing medical policy.

  • May be required to represent the company to external entities and/or serve on internal and/or external committees.

  • This level typically is more of a supportive position with oversight from a Medical Director.

  • May be responsible for a portion of a clinical program and/or performing clinical reviews.

  • Is more involved in supporting one or more Medical Directors, as well as the programs to which the Medical Director is assigned.

  • May manage pieces of programs, but would not have the full scope of program management expected of the Medical Director.

  • Receives guidance and oversight from a Medical Director who is an individual contributor in addition to direction received from immediate manager.

Minimum Requirements:

  • 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 New York and reside in New York.

  • 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.

  • For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Preferred Requirements:

  • Board certification in child and/or substance abuse.

CareMore is a proven care delivery model for the highest-risk.  We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.  We build and lead integrated, multi-disciplinary clinical teams to care for the most complex patients.  We strive for excellence and have achieved significant and measurable improvement in total cost of care, clinical outcomes, and experience.  As an Elevance Health subsidiary, we benefit from the scale and resources one of America’s largest managed healthcare organizations.
 

CareMore Medical Officer I – Des Moines, IA

Responsible for contributing to market clinical strategy, excellence and quality, and/or clinical oversight in one or more domains. Also responsible for providing internal medicine services to patients. This role is the entry level management job for the clinical leadership career path. Responsible for managing staff, as well as, performing administrative work. Primary duties may include, but are not limited to:

  • Assists market leadership in developing and executing comprehensive and coordinated clinical programs, improving clinical excellence and quality, and/or providing clinical oversight of care in one or more domains.

  • Makes hospital rounds daily. Provides patient care in one or more areas as physician on a daily basis.

  • Collaborates with hospitals and care management teams and reviews patients with case managers.

  • Works on call nights and weekends as scheduled.

  • Develops and improves training practices and materials.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Requirements:

  • Requires MD or DO and completion of residency in Internal Medicine, Family Medicine.

  • Minimum of 2 years of experience as a practicing physician in internal medicine, family medicine, geriatric medicine  

  • Requires current unrestricted medical licensure in Iowa or willing to apply for licensure.

  • Board eligibility or board certification in Family Medicine, Internal Medicine.

  • DEA license required.

  • For CareMore business units, satisfactory completion of a Tuberculosis test is a requirement for this position.

Preferred requirements:

  • 2+ years Leadership experience with responsibilities of managing direct and indirect reports

  • Experience driving KPI’s while understanding HEDIS scores with a keen eye to reduce gap closure
     

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $238,656 to $357,984

Locations:  Colorado; Nevada, Jersey City, NJ; New York City, NY; Ithica, NY and Westchester County, NY

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.  The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.


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. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

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 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 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. 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.

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