Elevance Health

Behavioral Health Medical Director- Child Psychiatrist

The Behavioral Health Medical Director- Child Psychiatrist completes medical necessity reviews for child psychiatry and Applied Behavioral Analysis cases supporting commercial and Medicaid business lines. This role involves conducting peer-to-peer clinical reviews, applying clinical knowledge to utilization review processes, adhering to medical policies, and engaging in activities that impact healthcare quality, cost, and outcomes.

Key Responsibilities
  • 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.
  • Applies clinical knowledge and skills to utilization review processes.
  • Adheres to medical policies and clinical guidelines.
  • As assigned, engage in clinical and non-clinical activities that impact health care quality cost and outcomes.
  • If requested, provides guidance for clinical operational aspects of a program.
  • May be required to serve on internal and/or external committees.
  • May develop and propose new medical policies based on changes in healthcare.
  • Identifies and develops opportunities for innovation to increase effectiveness and quality.
Required
  • 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.
  • 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 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.
Preferred
  • Willing to obtain a California medical license.
  • Board Certified in Child & Adolescent psychiatry strongly preferred.
Benefits & Perks
  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution

Behavioral Health Medical Director- Child Psychiatrist

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered.

Schedule: Fulltime position, Monday through Friday.

The Behavioral Health Medical Director- Child Psychiatrist is responsible for completing medical necessity reviews for general child psychiatry cases as well as Applied Behavioral Analysis cases supporting commercial and Medicaid business lines.

How you will make an impact:

  • 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.

  • Applies clinical knowledge and skills to utilization review processes.

  • Adheres to medical policies and clinical guidelines.

  • As assigned, engage in clinical and non-clinical activities that impact health care quality cost and outcomes

  • If requested, provides guidance for clinical operational aspects of a program.

  • May be required to serve on internal and/or external committees.

  • May develop and propose new medical policies based on changes in healthcare.

  • As assigned, engage in clinical and non-clinical activities that impact health care quality cost and outcomes.

  • Identifies and develops opportunities for innovation to increase effectiveness and quality.

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.

  • 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 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.

Preferred Qualifications:

  • Willing to obtain a California medical license.

  • Board Certified in Child & Adolescent psychiatry strongly preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $250,236 to $428,976.

Locations: California, Nevada, Colorado, Washington

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 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.


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 and Influenza. 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

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