Chief Medical Officer- Psychiatrist Carelon- Behavioral Health

Anticipated End Date:

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Job Description:

CMO CarelonBehavioral Health

Carelon Behavioral Health 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. Carelon Behavioral Health Health Options is a proud member of the Elevance Health Inc. family of companies.

Location:

Successful candidate must reside within 50 miles of an Elevance Health office location and able to commute onsite at least 3 days per week with strong preference given to Indianapolis IN Denver CO Wallingford CT Boston MA Chicago IL or Atlanta GA Woodland Hills CA.

Summary

The Behavioral Health Chief Medical Officer oversees Utilization Review Peer Review and the Regional CMOs and Medical Directors. He/she is responsible for leading the development of Company medical policies protocols criteria and guidelines to ensure best industry practices.

Team Scope

CMO will lead team of Medical Directors15 and span of control approx. 350

Position Responsibilities

Strategic Leadership and Planning

• Collaborates with the Executive Leadership Team on development and of strategic initiatives and program development to meet Carelon business needs.
• Serves as the principal medical manager and advisor to the Executive Leadership and Senior Leadership Teams in the areas of medical provider relations quality management utilization management clinical systems design and clinical operations.
• Provides broadbased leadership to all functional areas of the organization and participates in organizationwide strategic planning and program development.
• Collaborates in the formulation of clinical utilization and cost forecast. Monitors and executes control to meet budget targets.
• Demonstrates a strong business acumen and applies experiences managing large budgets and planning for achievement of short and longrange strategic objectives.
• As a strategic partner identifies emerging issues that impact company goals and develop strategies to resolve them collaborating with other organizational areas as needed.

Quality and Compliance Management

• Ensures highquality costeffective worksite and care management programs that meet Carelon Behavioral standards of clinical and quality performance.
• Ensures that Peer Advisors and Care Managers are rendering clinically appropriate and consistent decisions during review processes and complete documentation to ensure NCQA and URAC accreditation standards.
• Manages the Company Peer Advisor review process to ensure quality and consistent application of policies and protocols within the limits of the client benefit plans.
• Monitors compliance of state and federal regulatory requirements which apply to medical care issues.

Relationship and Stakeholder Management

• Ensures medical directors interface with key regional and corporate leadership and other internal and external customers to ensure optimal efficiency and quality of service.
• Establishes and maintains relationships with regional medical leaders of both state agencies and health delivery systems.

Operational Efficiency

• Leads Medical Affairs Committee and manages operations projects and audits to ensure organizational efficiency.
• Ensures the provision of counsel and leadership to various departments across the enterprise on functional and strategic initiatives and the measurement and management of risk.
• Develops and implements medical policy/procedures guidelines and accreditation compliant programs at every level and ensures continuous improvement in all practices.

Integration and Innovation

• Identifies opportunities to develop and implement integration between primary care and behavioral health services.

Ethical Standards

• Maintains ethical and professional standards.

Organizational Responsibility.

Thorough understanding of the Behavioral Health industry and the ways in which it supports contributes to and challenges the Carelon Behaviorals mission values and the key components of the companys strategic plan. Applies and integrates that knowledge in daily activities and longerterm transformational and strategic plans including:

• Development resource planning and of departmental and business goals and objectives.
• Identifying and optimizing opportunities in the workplace local community and legislative arenas to advance the understanding of mental health issues in support of Carelon Behavioral Healths mission to help people live their lives to the fullest potential.

Team Leadership and Development

Operates with integrity accountability and respect in daily work activities optimizing the contributions talent and results of employees and other resources to ensure every employee is effective accountable purposeful and purposeful in their role in driving the achievement of company business financial and community goals including:

• Implementing hiring developmental disciplinary and mentorship decisions and plans to support and strengthen both individuals and the team and the continued evolution of a high performing organization.
• Actively participates in performance management leadership development training succession planning and other Carelon Behavioral sponsored employee and leadership initiatives while also ensuring the active participation of direct reports and others included in these same programs.
• Care for individuals in our workforce by demonstrating and promoting respect trust empathy inclusion collaboration responsibility continuous improvement mentorship and wellbeing through a beneficial worklife balance.
• Recruits orients manages and documents performance of Medical Affairs staff. Manages workflow and Peer advisor productivity and performance as it impacts on utilization and other performance standards.
• Recruits orients develops and appraises assigned staff. Develops and motivates the team by creating a positive work environment facilitating training allocation of workflow and efforts towards improving professional capabilities.
• Coaches and mentors the team through established goals and performance expectations identifying and championing high performing and high potential talent.

Financial and Budgetary Responsibility

Plans an annual budget for area of responsibility whether departmental engagement center or other. Administers and optimizes the budget in:

• Daytoday administration of departmental activities strategic initiatives purchases and planning.
• Developing employees in personal and profession growth opportunities to increase employee engagement and commitment to Carelon Behavioral Health thereby decreasing costly turnover of skilled and knowledgeable high performing employees.
• Administers salary budget effectively making new hire promotional and other salaryrelated decisions with a full consideration of impact on the department the employee(s) and Carelon Behavioral.

Position Requirements

Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school and board certification in Psychiatry by the Board of Psychiatry and Neurology. Minimum of 10 years of clinical experience or any combination of education and experience which would provide an equivalent background. Eight years of postgraduate clinical practice plus two years of inpatient or hospitalbased treatment experience. Requires a current unrestricted medical license in psychiatry or osteopathy to practice independently in the state employed.

Preferred Skills Capabilities and Experiences

• Leadership & Utilization Management: Prior leadership role in a managed care environment and possess strong utilization management experience.
• Behavioral Health & Chemical Dependency: Substantial knowledge of behavioral health and chemical dependency services and treatment practices including a broad band of treatment techniques procedures and discharge planning
• Expertise in Digital & AI Decisioning: Demonstrated proficiency in utilizing digital and AI technologies to enhance decisionmaking processes. Ability to integrate and leverage datadriven insights to improve operational efficiencies and outcomes.
• Indepth Health Plan Experience: Extensive experience working within the health plan industry showcasing a deep understanding of the complexities and regulatory requirements. Proven track record in managing and optimizing health plans to meet organizational goals.
• Proven of Growth Strategies: Strong ability to develop and execute growth strategies that drive business expansion and enhance market positioning. Experience in identifying opportunities for innovation and successfully scaling organizational initiatives.
• Proven Collaboration with Internal and External Stakeholders: Excellent interpersonal and communication skills to effectively interact with and influence both internal teams and external partners. Experience in building and nurturing strong relationships to achieve common business objectives.
• Experience in Finalist Meetings: Demonstrated proficiency in preparing for and leading highstakes finalist meetings. Ability to persuasively present the organizations value proposition and successfully close deals or secure partnerships.

Corporate Title: Staff VP Medical Director

For candidates working in person or remotely in the below locations the salary* range for this specific position is $381100 to $438265.

California; Colorado; Connecticut; Massachusetts; Illinois; Indianna; Georgia

In addition to your salary Elevance Health offers benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate nondiscriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location work experience education and/or skill level. Even within the range the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned vested and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus commission benefits or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion consistent with the law.

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Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

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.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success for our consumers our associates our communities and our business.

We offer a range of marketcompetitive 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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates 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 1hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/memberfacing roles to become vaccinated against COVID19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

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 for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.