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Medical Director, Children's Behavioral Health
Location
United States
Posted
74 days ago
Salary
$202K - $303K / year
Seniority
Lead
No structured requirement data.
Job Description
Medical Director, Children's Behavioral Health
Excellus BlueCross BlueShield
Job Description: Summary: This position assists the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. This role supports the HARP line of business. Essential Accountabilities: Level I - Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for capitated providers. - Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. - Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Oversees the activities of physician advisors. Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies. - Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment. - Develops alliances with the provider community through the development and implementation of the medical management programs. May represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues, as needed. Represents the business unit at appropriate state committees and other ad hoc committees - Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values and adhering to the Corporate Code of Conduct. - Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. - Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information. - Regular and reliable attendance is expected and required. - Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) - Reviews medical literature and applies evidence-based principles using high proficiency skills for a broad range of clinical services. - Reviews internal trend reports to assess present and future needs and opportunities. - Interacts with regulatory and accreditation agencies as assigned. - Provides clinical support to the Sales and Marketing divisions - Provides clinical leadership for the implementation of new utilization/case/quality management initiatives Minimum Qualifications: Level I - Current New York State licensed physician. - Minimum 5 years of experience in a BH managed care settings or BH clinical setting (at least 2 of which are in a clinical setting). - Board certification in general psychiatry or certification in addiction medicine or certification in the subspecialty of addiction psychiatry. - Appropriate training and expertise in general psychiatry and/or addiction disorders. - Ability to identify, analyze and resolve complex medical issues. - Skills in evidence-based medicine. - Strong interpersonal skills essential for communication to staff at all levels of the organization., - Basic skill sets in electronic communication systems such as e-mail and Word. Level II (in addition to Level I Minimum Qualifications) - Superior evidence-based medicine skill set - Strong interpersonal skills essential for communication to physicians in the community. - Strong verbal presentation skills to lead internal and external discussions at board levels - Advanced skill sets in electronic communication systems such as e-mail, Word, PowerPoint, and Excel. Physical Requirements: - Works from a desk most of the time. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. Equal Opportunity Employer Compensation Range(s): $202,000.00 - $303,000.00 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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Field Clinical Specialist - Shockwave Medical (Northern Virginia)
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Job Function: MedTech Sales Job Sub Function: Clinical Sales – Hospital/Hospital Systems (Commission) Job Category: Professional All Job Posting Locations: Alexandria, Virginia, United States, Arlington, Virginia, United States, Fairfax, Virginia, United States, Winchester, Virginia, United States Job Description: Johnson & Johnson is hiring for a Field Clinical Specialist for Shockwave Medical Inc. located in Northern Virginia. At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow and profoundly impact health for humanity. Learn more at https://www.jnj.com/. 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The Field Clinical Specialist will also play a critical role in clinical studies including device training, case support and ensuring timely data collection for clinical programs. Case support may be required to support other territories at certain times. Essential Job Functions - Physician and hospital staff training, and procedural case coverage to ensure the safe and effective use of medical devices. - Effectively meet the needs of internal and external customers with a sense of urgency and drive. - Present clinical study training materials based on investigational plans to support the safe and effective use of medical devices, inclining study protocol, instructions for use, core lab manuals and case report forms. - Manage key study investigators; foster and maintain strong relationships through direct interactions with medical advisors and clinical leaders. - Partner with other clinical research colleagues to meet business needs in the field including site re-training, data collection for timely database locks and resolution of critical issues. - Administrative activities including training to procedures, manage territory travel and budgets. - Other duties as assigned. Qualifications - Minimum Bachelor’s Degree in business, science, nursing or related fields, or equivalent experience. - Minimum 2 years’ experience directly supporting interventional or surgical procedures within a hospital setting OR, 1 year of industry, hospital-based life sciences, sales support experience. Cardiovascular industry experience preferred but not required. - Working knowledge of clinical research, Good Clinical Practice (GCP) and regulatory compliance guidelines for clinical trials. - A history of effective collaboration with regulatory agencies through clinical studies and market releases. - Product knowledge including product vigilance and medical device reporting. - High attention to detail and accuracy. - Computer skills (MS Office products, word processing, spreadsheets, etc.). - Finance and budgeting knowledge. - Good prioritization and organizational skills. - Excellent critical thinking skills. - Excellent influencing and negotiation skills. - High energy and results-oriented individual who is mature and successful in a business environment and is skilled in motivating and inspiring people. - Entrepreneurial “hands-on” experience. Pro-active and “can do” attitude. - Ability to consider and accept feedback and suggestions for continuous improvement. - Works effectively on cross-functional teams. Demonstrated willingness to make decisions and to take responsibility for such. - Effective written, verbal and presentation skills with all levels of customers and management. - Ability to work in a fast-paced environment while managing multiple priorities - Operate as a team and/or independently while demonstrating flexibility to changing requirements. - There may be continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day) - Significant travel >50% of time requiring the employee to be effective in a remote manner. - Employee may be required to lift objects up to 40lbs or more. Employees will be required to work in an air conditioned office space and possibly perform some tasks in our non-temperature controlled warehouse space. Johnson & Johnson is an Equal Opportunity Employer. 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Required Skills: Preferred Skills: Business Behavior, Communication, Consulting, Cross-Selling, Customer Centricity, Customer Effort Score, Customer Retentions, Execution Focus, Goal Attainment, Hospital Operations, Innovation, Market Research, Medicines and Device Development and Regulation, Sales, Solutions Selling, Sustainable Procurement, Vendor Selection
Medical Science Liaison (MSL), Lung/GU/GI - Southeast Core (GA, SC, TN)
GlaxoSmithKline - GSKGlaxoSmithKline - GSK is one of the world's leading science and research-based pharmaceutical and healthcare companies. The company possesses a share of approxi
Cancer is unrelenting, but so are we. We strive to outpace cancer, improve patient outcomes, and enhance access to innovative therapies through leading science and technology via our talented people and strong partnerships. Our ambition is to help increase overall quality of life, maximize survival and change the course of disease, expanding our current focus on blood and women’s cancers into lung and gastrointestinal cancers, as well as other solid tumors. Every step is guided by patient and healthcare professional insights, ensuring we deliver meaningful innovation where it matters most. About your role If you are motivated by the opportunity to make a meaningful difference for patients with cancer, the Oncology Medical Science Liaison (MSL) role offers a highly impactful career path at GSK. As an Oncology MSL, you will bring strong clinical and therapeutic expertise and a solid understanding of the oncology landscape to engage with healthcare providers and key community and academic experts. Acting as a trusted medical resource, you will support clinical trials by facilitating relevant medical activities and collaborating with Medical Affairs and Clinical Operations colleagues. The MSL role is critical in identifying disease and product-related medical needs, capturing and communicating insights from the field, and supporting research activities and health innovations that contribute to improved patient care. This is a non-promotional, customer-facing, field-based role focused in assigned oncology therapeutic area. What you’ll do In this position, you’ll focus on advancing clinical practice within an assigned territory to improve patient outcomes and shape the future of oncology care. To reach this goal you will: - Engage relevant healthcare professionals and accounts (academic and community HCPs, pharmacists, physician assistants, nurses, etc.) using a data-driven approach based on scientific expertise and market knowledge, supplemented with MSL territory understanding, to address educational needs and inform medical plans. - Educate and engage HCPs & healthcare community on disease state, product information, emerging data, clinical trials, unmet medical needs, patient access barriers, and market dynamics; collect and communicate insights to influence medical strategy across the product lifecycle. - Develop and execute strategic territory and engagement plans aligned with medical strategy, including planning scientific interactions with key accounts and supporting clinical trials through relevant medical activities and cross-functional collaboration. - Act as a therapeutic area and GSK medicines resource for customers and internal colleagues by maintaining in-depth knowledge of the therapeutic landscape and anticipating customer educational needs. - Collaborate with internal stakeholders (Medical Affairs, Clinical Operations, Marketing, Sales, etc.) on a customer centric basis to deliver aligned medical solutions and participate in Field Medical or cross enterprise projects supporting medical strategies. - Comply with GSK policies, Code of Conduct and ways of working; complete required training, documentation and administrative responsibilities in a timely, compliant manner. Why you? Basic Qualifications: We are seeking professionals with the following required skills to achieve our goals: - Must reside within territory for consideration with access to a major airport. - Doctorate in a clinical/medical field (PharmD, PhD, MD), or a master's in advanced science/clinical/healthcare (e.g., MSN, ANP, MS, MPH) - Oncology, pharmaceutical industry, clinical or academic experience. - 2 plus years of clinical or industry experience in oncology, hematology, rare disease, or another closely related therapeutic area. - Experience engaging in peer-to-peer scientific dialogue with medical professionals and decision makers. - Experience in delivering medical-based presentations. - Experience identifying opportunities for medical engagement and developing scientific engagement goals. - Experience working with external HCPs, experts, and internal stakeholders. - Must be able to manage designated territory with 60-75% travel. Preferred Qualifications: If you have the following characteristics, it would be a plus: - Previous clinical experience in situations where direct/or indirect decision-making authority for patient care was demonstrated (e.g., direct patient care, treatment protocol development, drug therapy guidelines development, traditional clinical pharmacy practice settings). - Above average computer literacy (e.g. utilizing AI and digital fluency), including experience with software applications. #LI-Remote #MSL_Onc Please visit GSK US Benefits Summary to learn more about the comprehensive benefits program GSK offers US employees. Why GSK? Uniting science, technology and talent to get ahead of disease together. GSK is a global biopharma company with a purpose to unite science, technology and talent to get ahead of disease together. We aim to positively impact the health of 2.5 billion people by the end of the decade, as a successful, growing company where people can thrive. We get ahead of disease by preventing and treating it with innovation in specialty medicines and vaccines. We focus on four therapeutic areas: respiratory, immunology and inflammation; oncology; HIV; and infectious diseases – to impact health at scale. People and patients around the world count on the medicines and vaccines we make, so we’re committed to creating an environment where our people can thrive and focus on what matters most. Our culture of being ambitious for patients, accountable for impact and doing the right thing is the foundation for how, together, we deliver for patients, shareholders and our people. If you require an accommodation or other assistance to apply for a job at GSK, please contact the appropriate Recruitment Staff by emailing us at - usrecruitment.adjustments@gsk.com GSK is an Equal Opportunity Employer. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), military service or any basis prohibited under federal, state or local law. Important notice to Employment businesses/ Agencies GSK does not accept referrals from employment businesses and/or employment agencies in respect of the vacancies posted on this site. All employment businesses/agencies are required to contact GSK's commercial and general procurement/human resources department to obtain prior written authorization before referring any candidates to GSK. The obtaining of prior written authorization is a condition precedent to any agreement (verbal or written) between the employment business/ agency and GSK. In the absence of such written authorization being obtained any actions undertaken by the employment business/agency shall be deemed to have been performed without the consent or contractual agreement of GSK. GSK shall therefore not be liable for any fees arising from such actions or any fees arising from any referrals by employment businesses/agencies in respect of the vacancies posted on this site. Please note that if you are a US Licensed Healthcare Professional or Healthcare Professional as defined by the laws of the state issuing your license, GSK may be required to capture and report expenses GSK incurs, on your behalf, in the event you are afforded an interview for employment. This capture of applicable transfers of value is necessary to ensure GSK’s compliance to all federal and state US Transparency requirements. For more information, please visit the Centers for Medicare and Medicaid Services (CMS) website at https://openpaymentsdata.cms.gov/
Medical Science Liaison (MSL), Lung/GU/GI - Southeast Core (GA, SC, TN)
GlaxoSmithKline - GSKGlaxoSmithKline - GSK is one of the world's leading science and research-based pharmaceutical and healthcare companies. The company possesses a share of approxi
Site Name: Field Worker - USA Posted Date: Apr 9 2026 Cancer is unrelenting, but so are we. We strive to outpace cancer, improve patient outcomes, and enhance access to innovative therapies through leading science and technology via our talented people and strong partnerships. Our ambition is to help increase overall quality of life, maximize survival and change the course of disease, expanding our current focus on blood and women’s cancers into lung and gastrointestinal cancers, as well as other solid tumors. Every step is guided by patient and healthcare professional insights, ensuring we deliver meaningful innovation where it matters most. About your role If you are motivated by the opportunity to make a meaningful difference for patients with cancer, the Oncology Medical Science Liaison (MSL) role offers a highly impactful career path at GSK. As an Oncology MSL, you will bring strong clinical and therapeutic expertise and a solid understanding of the oncology landscape to engage with healthcare providers and key community and academic experts. Acting as a trusted medical resource, you will support clinical trials by facilitating relevant medical activities and collaborating with Medical Affairs and Clinical Operations colleagues. The MSL role is critical in identifying disease and product-related medical needs, capturing and communicating insights from the field, and supporting research activities and health innovations that contribute to improved patient care. This is a non-promotional, customer-facing, field-based role focused in assigned oncology therapeutic area. What you’ll do In this position, you’ll focus on advancing clinical practice within an assigned territory to improve patient outcomes and shape the future of oncology care. To reach this goal you will: - Engage relevant healthcare professionals and accounts (academic and community HCPs, pharmacists, physician assistants, nurses, etc.) using a data-driven approach based on scientific expertise and market knowledge, supplemented with MSL territory understanding, to address educational needs and inform medical plans. - Educate and engage HCPs & healthcare community on disease state, product information, emerging data, clinical trials, unmet medical needs, patient access barriers, and market dynamics; collect and communicate insights to influence medical strategy across the product lifecycle. - Develop and execute strategic territory and engagement plans aligned with medical strategy, including planning scientific interactions with key accounts and supporting clinical trials through relevant medical activities and cross-functional collaboration. - Act as a therapeutic area and GSK medicines resource for customers and internal colleagues by maintaining in-depth knowledge of the therapeutic landscape and anticipating customer educational needs. - Collaborate with internal stakeholders (Medical Affairs, Clinical Operations, Marketing, Sales, etc.) on a customer centric basis to deliver aligned medical solutions and participate in Field Medical or cross enterprise projects supporting medical strategies. - Comply with GSK policies, Code of Conduct and ways of working; complete required training, documentation and administrative responsibilities in a timely, compliant manner. Why you? Basic Qualifications: We are seeking professionals with the following required skills to achieve our goals: - Must reside within territory for consideration with access to a major airport. - Doctorate in a clinical/medical field (PharmD, PhD, MD), or a master's in advanced science/clinical/healthcare (e.g., MSN, ANP, MS, MPH) - Oncology, pharmaceutical industry, clinical or academic experience. - 2 plus years of clinical or industry experience in oncology, hematology, rare disease, or another closely related therapeutic area. - Experience engaging in peer-to-peer scientific dialogue with medical professionals and decision makers. - Experience in delivering medical-based presentations. - Experience identifying opportunities for medical engagement and developing scientific engagement goals. - Experience working with external HCPs, experts, and internal stakeholders. - Must be able to manage designated territory with 60-75% travel. Preferred Qualifications: If you have the following characteristics, it would be a plus: - Previous clinical experience in situations where direct/or indirect decision-making authority for patient care was demonstrated (e.g., direct patient care, treatment protocol development, drug therapy guidelines development, traditional clinical pharmacy practice settings). - Above average computer literacy (e.g. utilizing AI and digital fluency), including experience with software applications. #LI-Remote #MSL_Onc Please visit GSK US Benefits Summary to learn more about the comprehensive benefits program GSK offers US employees. Why GSK? Uniting science, technology and talent to get ahead of disease together. GSK is a global biopharma company with a purpose to unite science, technology and talent to get ahead of disease together. We aim to positively impact the health of 2.5 billion people by the end of the decade, as a successful, growing company where people can thrive. We get ahead of disease by preventing and treating it with innovation in specialty medicines and vaccines. We focus on four therapeutic areas: respiratory, immunology and inflammation; oncology; HIV; and infectious diseases – to impact health at scale. People and patients around the world count on the medicines and vaccines we make, so we’re committed to creating an environment where our people can thrive and focus on what matters most. Our culture of being ambitious for patients, accountable for impact and doing the right thing is the foundation for how, together, we deliver for patients, shareholders and our people. If you require an accommodation or other assistance to apply for a job at GSK, please contact the appropriate Recruitment Staff by emailing us at - usrecruitment.adjustments@gsk.com GSK is an Equal Opportunity Employer. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), military service or any basis prohibited under federal, state or local law. Important notice to Employment businesses/ Agencies GSK does not accept referrals from employment businesses and/or employment agencies in respect of the vacancies posted on this site. All employment businesses/agencies are required to contact GSK's commercial and general procurement/human resources department to obtain prior written authorization before referring any candidates to GSK. The obtaining of prior written authorization is a condition precedent to any agreement (verbal or written) between the employment business/ agency and GSK. In the absence of such written authorization being obtained any actions undertaken by the employment business/agency shall be deemed to have been performed without the consent or contractual agreement of GSK. GSK shall therefore not be liable for any fees arising from such actions or any fees arising from any referrals by employment businesses/agencies in respect of the vacancies posted on this site. Please note that if you are a US Licensed Healthcare Professional or Healthcare Professional as defined by the laws of the state issuing your license, GSK may be required to capture and report expenses GSK incurs, on your behalf, in the event you are afforded an interview for employment. This capture of applicable transfers of value is necessary to ensure GSK’s compliance to all federal and state US Transparency requirements. For more information, please visit the Centers for Medicare and Medicaid Services (CMS) website at https://openpaymentsdata.cms.gov/

