What are the responsibilities and job description for the Medical Director Associate position at Anthem?
Job ID:JP00046737
Anticipated Start Date: 08/31/2026
Please note this is the target date and is subject to change. BCForward will send official notice ahead of a confirmed start date.
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.
Responsible for providing day-to-day guidance, support, and leadership for clinical and/or quality activities under the guidance of a Medical Director. May be responsible for supporting one or more Medical Directors in ensuring clinical integrity of broad and significant clinical programs. May perform clinical review.
Primary duties may include, but are not limited to:
Provides clinical guidance for programs in the various fields of psychiatry, including general adult, addiction, and child and adolescent psychiatry.
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 participate in a physician on-call rotation for a 24x7 unit.
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.
May be required to represent the company to external entities and/or serve on internal and/or external committees.
Associate Medical Director for the Child & Family Division: The Associate Medical Director is responsible for providing day-to-day guidance, support, and leadership for clinical and/or quality activities under the guidance of a Medical Director, in support of programs related to the Rural Health Transformation Program.
Also responsible for supporting one or more Medical Directors in ensuring clinical integrity of broad and significant clinical and other contracted programs.
Support the Access Mental Health Expansions under the Rural Health Transformation Program
Supports and provide supervision for internal clinicians regarding clinical matters related to programs under the rural health grant.
Support and provide oversight to contracted Hubs medical teams.
May be responsible for a portion of a clinical program and/or performing clinical reviews.
Serves as a resource and consultant to other areas of the company. Interpret existing medical policy.
The Associate Medical Director will provide clinical case consultation, training, and staff development and will provide clinical expertise as needed to staff, in child/youth and family meetings, provider meetings, contracted HUBs, and community meetings in locations that are delivering care and/or services under the scope of the contract.
May manage pieces of programs, but would not have the full scope of program management expected of the Medical Director.
Receives guidance and oversight from a Medical Director who is an individual contributor in addition to direction received from immediate manager.
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).
The Medical Director will be board-certified in psychiatry by the American Board of Psychiatry and Neurology (ABPN) and
be board certified or eligible for child & adolescent psychiatry through the ABPN;Must possess an active unrestricted medical license to practice medicine in the state of Connecticut. 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 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Must have at least five (5) years of demonstrated post-training experience working with children/youth and families and at least three (3) years leadership experience.
Preferred Skills, Capabilities, and Experiences:
• Demonstrated clinical experience and expertise in the field of child & adolescent psychiatry,
• General psychiatry
• Autism
• School-based mental health
• Addiction psychiatry or treatment of substance use disorders
Job Type: Contract opportunity.
Additional Details:
Must be licensed and reside in Connecticut.
17.5 hours per week
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
About BCForward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.
Salary : $109 - $157