Anthem, Inc. Behavioral Health Medical Director in Fresno, California
SHIFT: Day Job
Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination. It’s 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.
For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Location: This position offers works from home. CA residence preferred.
This position will involve utilization management review as well as external clinical outreach and partnering with the account management team to provide clinical oversight of the Orange County contract as well as other Medicaid contracts across the organization.
The Behavioral Health Medical Director is responsible for the administration of 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 for 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-effectiveness, 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. required.
Active unrestricted medical license to practice medicine or a health profession in California required.
Board Certified by the American Board of Psychiatry and Neurology in Psychiatry.
At least 5 years of post-residency clinical experience required.
Experience working in a leadership/managerial position preferred.
California resident preferred.
Ability to work collaboratively with a multi-disciplinary team required.
Utilization Management and managed care experience required.
Some local travel in the state of CA may be required (post-COVID).
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. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.