Behavioral Health Medical Director - Psychiatrist - North Carolina
Location: NC-WINSTON-SALEM, 5650 UNIVERSITY PKWY, North Carolina
Time Type: Full time
Posted On: Posted 2 Days Ago
End Date: December 1, 2024 (30+ days left to apply)
Job Requisition ID: JR129759
Position Title: Behavioral Health Medical Director - Psychiatrist - North Carolina
Job Description:
Please note: The successful candidate will be a licensed and domiciled psychiatrist in the state of North Carolina and will preferably hold a Child & Adolescent Board Certification. This is a hybrid role where the new hire may get asked to work in our Durham, NC or Winston-Salem, NC office 1-2x a week.
The Behavioral Health Medical Director – Psychiatrist - North Carolina is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to improve quality, cost, and outcomes.
Primary Duties:
- 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 to 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.
Position Requirements:
- Requires MD or DO and Board certification approved by one of the following certifying boards is required: 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.
- 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, minimum of 5 years of experience providing health care is required.
- For URAC accredited areas, strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills are expected.
Preferred Qualifications:
- Board Certified in Child & Adolescent psychiatry is strongly preferred.
- At least 2+ years’ experience in managed care.
- Experience working with children, youth and families served by the child welfare system.
Job Level: Director Equivalent
Workshift: 1st Shift (United States of America)
Job Family: MED > Licensed Physician/Doctor/Dentist
Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company looking for leaders who are passionate about making an impact on our members and communities.
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, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status protected by applicable laws.
#J-18808-Ljbffr
