Medical Director-PSCCR at Elevance Health

Costa Mesa, California, United States

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Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Candidates must hold an MD or DO degree and be board-certified by the ABMS or AOA, where applicable. An active, unrestricted medical license to practice medicine is required. A minimum of 10 years of clinical experience is necessary, with an additional 5 years of healthcare provision experience required for Health Solutions roles. Associates must possess strong oral, written, and interpersonal communication skills, along with problem-solving abilities.

Responsibilities

The Medical Director-PSCCR will administer physical and/or behavioral health medical services to ensure appropriate and cost-effective care, potentially developing programs to improve quality, cost, and outcomes. They will provide clinical consultation and strategic advice, identify cost-saving opportunities, and serve as a resource to staff, including other Medical Directors. Responsibilities include supporting clinicians, guiding clinical operations, conducting peer-to-peer reviews with physicians, interpreting and developing medical policies, and leading initiatives to enhance healthcare quality and outcomes. The role may involve program management, including policy development, overseeing clinical and non-clinical activities, and representing the company externally.

Skills

medical administration

clinical operations

peer-to-peer clinical reviews

clinical consultation

program development

quality improvement

cost of care analysis

staff advisory

committee leadership

healthcare leadership

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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