Medical Director Associate- NH
Elevance Health

Job Info

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Description

Medical Director Associate

Location: Hybrid position, must reside in New Hampshire or able to commute to in-person meetings in NH.

Build the Possibilities. Make an extraordinary impact.

Responsible for providing day-to-day guidance, support, and leadership for clinical and/or quality activities under the guidance of a Medical Director Manager. May be responsible for supporting one or more Medical Directors in ensuring clinical integrity of broad and significant clinical programs. May perform clinical review. This role will interface closely with the New Hampshire Department of Health and Human Services to help strategize and address the substance use crisis in the state.

How you will make an impact:

• Clinical consultation on individual cases.
  
• Clinical staff supervision.
  
• Oversight and guidance of American Society of Addiction Medicine (ASAM) assessments and SUD treatment protocols.
  
• Strategic planning for increasing the use of Medication Assistance Treatment
  
• Engagements with Peer Recovery Support Services.
  
• Oversight of discharge planning for members who visit an emergency department or are hospitalized for an overdose.
  
• Available to the MCM program on a routine basis for consultations on MCO clinical policy related to Substance Use Disorders and the cases of individual Members, as needed.
  
• 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 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.
  

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 Hampshire, or willing to obtain NH licensure.
  
• Minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
  

Preferred Qualifications:

• Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  
• Experience with treating substance abuse is preferred.
  

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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