Behavioral Health Medical Director - Psychiatrist - Kansas
Company: Elevance Health
Location: Topeka
Posted on: April 30, 2024
Job Description:
Position specific details: The successful hire will be a
board-certified psychiatrist and addictionologist (or has approved
addictions experience, and is a licensed physician in the State of
Kansas and who has at least five (5) years combined experience in
mental health and SUD services. Residency in KS is required. Open
to candidates in Kansas City, Topeka, Wichita, Lawrence, Manhattan
and Leavenworth. Relocation assistance available. The Medical
Director - KS shall oversee and be responsible for all Behavioral
Health activities, including oversight of coordination activities
with the state and shall work closely with the Behavioral Health
Director and other Medical Officers to ensure the delivery of
holistic and integrated person-centered care. The Medical Director
typically has program management responsibilities including
clinical policy development, programdevelopment/implementation,and
overseeingclinical/non-clinicalactivities. Responsible for the
administration of behavioral health medical services for the state
program, 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. May
provide clinical consultation and serve as clinical/strategic
advisor to enhance clinical operations. May identify cost of care
opportunities. May serve as a resource to staff including Medical
Director Associates. May be responsible for performing clinical
reviews. Primary duties may include, but are not limited to:
- 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.
- Identifies and develops opportunities for innovation to
increase effectiveness and quality. Position 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), American Osteopathic Association (AOA).
- Additional board certification in addictions is required.
- Must possess an active unrestricted Kansas 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 (including
behavioral health) only, 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. 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. 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. If this job is
assigned to any Government Business Division entity, the applicant
and incumbent fall under a sensitive position' work designation and
may be subject to additional requirements beyond those associates
outside Government Business Divisions. Requirements include but are
not limited to more stringent and frequent background checks and/or
government clearances, segregation of duties, principles, role
specific training, monitoring of daily job functions, and sensitive
data handling instructions. Associates in these jobs must follow
the specific policies, procedures, guidelines, etc. as stated by
the Government Business Division in which they are employed.
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Keywords: Elevance Health, Kansas City , Behavioral Health Medical Director - Psychiatrist - Kansas, Executive , Topeka, Kansas
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