Manager, Medical Director - Behavioral Health (Medicaid and Commercial)
Elevance Health, Walnut Creek, California, United States, 94598
Anticipated End Date
2026-02-27 Position Title
Manager, Medical Director - Behavioral Health (Medicaid and Commercial) Job Description
Manager, Medical Director- Behavioral Health (Medicaid and Commercial) Location
This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates reside within a commuting distance from an office. Ideal candidates will live in California. Role Summary
The Manager, Medical Director is responsible for the administration of medical services for external accounts – Medicaid and Commercial – 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. How you make an impact
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 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; conducts 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. Hires, trains, coaches, counsels, and evaluates performance of direct reports and directly supervises the management of any assigned staff. Minimum Requirements
Requires MD/DO and Board certification approved by one of the following certifying boards where applicable to duties being performed: American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). Must possess an active unrestricted medical license to practice medicine or a health profession in California. 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 10 years of clinical experience, or any combination of education and experience providing an equivalent background. Preferred Qualifications
Management experience preferred. Managed care experience preferred. Ability to obtain a California license. Addiction or Child and Adolescent experience/certification is preferred. For candidates working in person or virtually in the below locations, the salary range for this specific position is $325,680.00 to $509,760.00. Location
California Compensation and Benefits
In addition to 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 is based on a number of legitimate, non-discriminatory factors set by the Company. Elevance Health is committed to equal pay for equal work regardless of gender, race, or other protected categories. * The salary range is the range Elevance Health believes is the range of possible compensation for this role at the time of posting. This range may be modified in the future and actual compensation may vary based on geographic location, work experience, education, and/or skill level. No wages or compensation are guaranteed until earned. Bonus, commissions, benefits, or any other form of compensation are at the Company’s discretion as allowed by law. Job Level
Director Workshift
1st Shift (United States of America) Job Family
MED > Licensed Physician/Doctor/Dentist Elevance Health reserves the right to request resumes only from agencies with a signed agreement. Unsolicited resumes are 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
We are creating a culture that advances our strategy and supports personal and professional growth. Our values and behaviors drive our culture, outcomes, and shared success for consumers, associates, communities, and the business. We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs, medical, dental, vision, disability coverage, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, subject to eligibility. Elevance Health operates 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 onsite requirements will be discussed during the hiring process. The health of our associates and communities is a top priority. Some patient/member-facing roles may require vaccination against COVID-19 and Influenza. Elevance Health will follow all relevant 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, gender identity or expression, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other protected status. Applicants who require accommodation may contact the appropriate support channel for assistance. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws. Prospective employees may need to review Florida screening resources as applicable.
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2026-02-27 Position Title
Manager, Medical Director - Behavioral Health (Medicaid and Commercial) Job Description
Manager, Medical Director- Behavioral Health (Medicaid and Commercial) Location
This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates reside within a commuting distance from an office. Ideal candidates will live in California. Role Summary
The Manager, Medical Director is responsible for the administration of medical services for external accounts – Medicaid and Commercial – 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. How you make an impact
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 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; conducts 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. Hires, trains, coaches, counsels, and evaluates performance of direct reports and directly supervises the management of any assigned staff. Minimum Requirements
Requires MD/DO and Board certification approved by one of the following certifying boards where applicable to duties being performed: American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). Must possess an active unrestricted medical license to practice medicine or a health profession in California. 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 10 years of clinical experience, or any combination of education and experience providing an equivalent background. Preferred Qualifications
Management experience preferred. Managed care experience preferred. Ability to obtain a California license. Addiction or Child and Adolescent experience/certification is preferred. For candidates working in person or virtually in the below locations, the salary range for this specific position is $325,680.00 to $509,760.00. Location
California Compensation and Benefits
In addition to 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 is based on a number of legitimate, non-discriminatory factors set by the Company. Elevance Health is committed to equal pay for equal work regardless of gender, race, or other protected categories. * The salary range is the range Elevance Health believes is the range of possible compensation for this role at the time of posting. This range may be modified in the future and actual compensation may vary based on geographic location, work experience, education, and/or skill level. No wages or compensation are guaranteed until earned. Bonus, commissions, benefits, or any other form of compensation are at the Company’s discretion as allowed by law. Job Level
Director Workshift
1st Shift (United States of America) Job Family
MED > Licensed Physician/Doctor/Dentist Elevance Health reserves the right to request resumes only from agencies with a signed agreement. Unsolicited resumes are 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
We are creating a culture that advances our strategy and supports personal and professional growth. Our values and behaviors drive our culture, outcomes, and shared success for consumers, associates, communities, and the business. We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs, medical, dental, vision, disability coverage, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, subject to eligibility. Elevance Health operates 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 onsite requirements will be discussed during the hiring process. The health of our associates and communities is a top priority. Some patient/member-facing roles may require vaccination against COVID-19 and Influenza. Elevance Health will follow all relevant 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, gender identity or expression, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other protected status. Applicants who require accommodation may contact the appropriate support channel for assistance. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws. Prospective employees may need to review Florida screening resources as applicable.
#J-18808-Ljbffr