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Behavioral Health Medical Director - MN Preferred (Remote) - PS26022

Anthem Middletown, NY
  • Expired: August 25, 2019. Applications are no longer accepted.

Behavioral Health Medical Director - MN Preferred (Remote) - PS26022
Location: United States
Requisition #: PS26022
Post Date: 2 hours ago
Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care .
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.
Responsible for the administration of Behavioral Health medical services for company health plans including the overall medical policies of the business unit to ensure the appropriate and most cost effective medical care is received and collaborates with other clinical leadership in the day-to-day management of medical management staff.
Primary duties may include, but are not limited to:

  • Interprets existing policies and develops new policies based on changes in the healthcare or medical arena.
  • 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.
  • Serves as a resource and consultant to other areas of the company, may chair or serve on company committees, may be required to represent the company to external entities and/or serve on external committees, conduct peer clinical and/or appeal case reviews and peer to peer clinical reviews with attending physicians or other ordering providers to discuss review determinations, provides guidance for clinical operational aspects of the program.
  • Supports the medical management staff ensuring timely and consistent responses to members and providers.
  • M.D. or D.O.
  • Active, unrestricted license to practice medicine in the state of residence.
  • Ability to obtain an active, unrestricted license to practice medicine in the state pf MN required (expenses will be reimbursed).
  • Current Board Certification by the American Board of Psychiatry and Neurology required.
  • 10 years of clinical experience or any combination of education and experience, which would provide an equivalent background; minimum of 5 years of children's behavioral health clinical experience
  • Experience working with Medicaid preferred.
  • Utilization Management experience preferred.
  • MN resident a plus.
  • 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.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.



Middletown, NY
10940 USA