PSYCHIATRY- FIELD MEDICAL DIRECTOR
Company: Evolent Health
Location: Olympia
Posted on: October 7, 2024
Job Description:
Your Future Evolves HereEvolent partners with health plans and
providers to achieve better outcomes for people with most complex
and costly health conditions. Working across specialties and
primary care, we seek to connect the pieces of fragmented health
care system and ensure people get the same level of care and
compassion we would want for our loved ones.Evolent employees enjoy
work/life balance, the flexibility to suit their work to their
lives, and autonomy they need to get things done. We believe that
people do their best work when they're supported to live their best
lives, and when they feel welcome to bring their whole selves to
work. That's one reason why diversity and inclusion are core to our
business.Join Evolent for the mission. Stay for the culture.What
You'll Be Doing:As a Behavioral Health Field Medical Director will
be a key member of the utilization management team. We can offer
you a meaningful way to make a difference in patients lives, in a
non-clinical environment. You can enjoy better work- life balance
on a team that values collaboration and continuous learning while
providing better health outcomes. We believe in embracing new
ideas, challenging ourselves and failing forward. We have fun while
working hard and often make a difference in everything from scrubs
to jeans.Collaboration Opportunities:Evolent Health is looking for
a Behavioral Health Medical Director to be a member of the Evolent
clinical team. As a collaborative member of a team of clinicians,
physicians, pharmacists, health economists, and program
coordinators, you will have the opportunity to make a profound
impact on the lives of our members. Routinely interacts with
leadership and management staff, other Physicians, and staff
whenever a physician`s input is needed or required. As well as,
aids and acts as a resource to Initial Clinical Reviewers.What
you'll be doing:
- Supports pre-admission review, utilization management, and
concurrent and retrospective review process.
- Participates in risk management, claim adjudication, pharmacy
utilization management, catastrophic case review, outreach
programs,
- Assists with execution of Evolent's benchmarked
Utilization/Cost Management Program and relevant Clinical Quality
Improvement Programs
- Participate in the Appeals and Grievance process, as necessary,
to assure timely and accurate responses to members
- Supports design and implementation of health plan medical
policies, and appropriate Care Management and UM goals and
objectives
- Population health - collaborative care management
leadership
- Provides clinical leadership and development for population
health programs or functional areas within Medical Management.
- Assists in assuring appropriate health care delivery for the
assigned membership and managing the medical costs associated with
the assigned population.
- Promotion of managed care systems using evidence-based medicine
to educate and facilitate best practices with care management staff
and medical providers.
- Participate in committees as assigned.
- Provides guidance and interpretation on issues of medical
appropriateness, benefit application as appropriate, level of care
necessary to include out-of-network care.
- Evaluates and ensures systems and processes to assist providers
with adherence to evidence based protocols
- Assures compliance related to Federal (e.g., CMS), State (e.g.,
Insurance commission) and local rules and
regulations.Qualifications :
- Board Certification in Psychiatry
- Graduate of an accredited medical school. Either MD or DO
degree is required.
- Active physician license without any restrictions.
- 3-5 years of clinical practice in a primary care setting and
progressively responsible medical administrative experience
preferred.
- Proven ability in medical leadership position possessing
clinical credibility with peers and the ability to be a team player
and team builder.
- A thorough understanding of all aspects of managed care,
including HMOs, PHOs, risk arrangements, capitation, peer review,
performance profiling, outcome management, care coordination,
pharmacy management, and patient centered medical home
concepts.
- Excellent interpersonal, verbal, and written communication
skills.
- Consistently completes continuing education activities relevant
to practice area and needed to maintain licensure.
- Ability to navigate in a corporate matrix environment is
preferred.Technical Requirements:We require that all employees have
the following technical capability at their home: High speed
internet over 10 Mbps and, specifically for all call center
employees, the ability to plug in directly to the home internet
router. These at-home technical requirements are subject to change
with any scheduled re-opening of our office locations.Evolent is an
equal opportunity employer and considers all qualified applicants
equally without regard to race, color, religion, sex, sexual
orientation, gender identity, national origin, veteran status, or
disability status. If you need reasonable accommodation to access
the information provided on this website, please contact
recruiting@evolent.com for further assistance.The expected base
salary/wage range for this position is $120-130/hr. This position
is also eligible for a bonus component that would be dependent on
pre-defined performance factors. As part of our total compensation
package, Evolent is proud to offer comprehensive benefits
(including health insurance benefits) to qualifying employees. All
compensation determinations are based on the skills and experience
required for the position and commensurate with experience of
selected individuals, which may vary above and below the stated
amounts.Don't see the dream job you are looking for? Drop off your
contact information and resume and we will reach out to you if we
find the perfect fit!For more insights about Evolent Health, click
on Life At Evolent (https://www.evolent.com/) to learn more!
Keywords: Evolent Health, Kent , PSYCHIATRY- FIELD MEDICAL DIRECTOR, Executive , Olympia, Washington
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