Behavioral Health Medical Director- ABA Child Psychiatrist

Elevance Health; Costa Mesa (CA); On-site; USD 250,000 - 429,000; Full time

Job summary

An established industry player is seeking a Behavioral Health Medical Director specializing in ABA Child Psychiatry. This pivotal role involves conducting medical necessity reviews and engaging in utilization review processes to ensure high-quality healthcare delivery. The position offers a hybrid work environment, allowing for both remote and office work, and is ideal for a seasoned professional with extensive clinical experience. Join a forward-thinking organization that values innovation and quality in healthcare, while enjoying a comprehensive benefits package and competitive salary range. If you are passionate about improving healthcare outcomes, this opportunity is for you.

Benefits

Comprehensive Benefits Packages

Incentive Programs

Stock Purchase

401k Plan

Qualifications

• 10+ years of clinical experience or equivalent education.
• Board Certified in Child & Adolescent Psychiatry preferred.

Responsibilities

• Conduct peer-to-peer clinical reviews with providers.
• Engage in activities impacting healthcare quality and cost.
• Identify opportunities for innovation in healthcare.

Skills

Clinical Knowledge

Utilization Review

Medical Policy Development

Education

MD or DO with Board Certification

Active Unrestricted Medical License in California

Job description

Behavioral Health Medical Director- ABA Child Psychiatrist

Job Details

Locations: CA-COSTA MESA, 3080 BRISTOL ST, STE 200; CA-WOODLAND HILLS, 21215 BURBANK BLVD; CA-WALNUT CREEK, 2121 N CALIFORNIA BLVD, 7TH FL; NV-LAS VEGAS, 3634 S MARYLAND PKWY; CO-DENVER, 700 BROADWAY

Type: Full time; posted 9 days ago; apply by May 16, 2025

Position Overview

The Behavioral Health Medical Director- ABA Child Psychiatrist is responsible for medical necessity reviews for Applied Behavioral Analysis cases supporting commercial and Medicaid lines. The position involves hybrid work (remote and office), with candidates required to reside within 50 miles of an Elevance Health Pulse Point location.

Key Responsibilities

• Conduct peer-to-peer clinical reviews with providers regarding review determinations and patient visits.
• Apply clinical knowledge to utilization review processes.
• Follow medical policies and clinical guidelines.
• Engage in activities impacting healthcare quality, cost, and outcomes.
• Provide guidance on clinical operational aspects as needed.
• May serve on committees and develop medical policies based on healthcare changes.
• Identify opportunities for innovation to improve effectiveness and quality.

Minimum Qualifications

• MD or DO with Board certification (ABMS or AOA).
• Active unrestricted medical license in California.
• At least 10 years of clinical experience, or equivalent education and experience.
• For Health Solutions and Carelon organizations, a minimum of 5 years healthcare experience.

Preferred Qualifications

• Willingness to obtain Indiana medical license.
• Board Certified in Child & Adolescent Psychiatry (strongly preferred).

Additional Information

Salary range: $250,236 to $428,976, based on location and experience. Benefits include comprehensive packages, incentive programs, stock purchase, 401k, and more. Candidates must reside within 50 miles of an Elevance Health location and comply with vaccination policies. Elevance Health is an Equal Opportunity Employer.