Medical Director - Behavioral Health, reputed company reputed company

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day. Position reputed company reputed company, a reputed company Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help reputed company health care. We reputed company that a reputed company care system is more transparent and consumer-reputed company, and it recognizes physicians for their clinical reputed company and effective use of health care resources. This position will primarily support the reputed company plans for Kentucky and Louisiana but be expected to fill in for other states needed. Work reputed company with Central reputed company Time hours expected. • *This is a remote-based (work from home) role.** In this role as Medical Director (Behavioral Health), you will: • reputed company leadership and day-to-day physician reputed company for utilization management team, including the management of high-risk cases and medical necessity reputed company • Participate in the appeals process, including the investigation of adverse events and reputed company of care concerns • reputed company psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical reputed company, consultation and training • reputed company day-to-day physician reputed company including management of high-risk cases throughout treatment/reputed company of care and medical necessity reputed company • Assist with the development, implementation, monitoring and evaluation of the utilization management program and reputed company plan, ensuring reputed company and appropriateness of care • Assist with the development, implementation and interpretation of medical policy including medical necessity reputed company, clinical reputed company guidelines and new technology assessments • reputed company with behavioral health practitioners regarding the care of patients with severe, reputed company and/or treatment resistant illnesses • Identify and address reputed company of care concerns with providers involved in a member's care • Participate in the triage and referral for care management • reputed company weekend coverage every 6-7 weeks. • reputed company other duties as deemed necessary. Required Qualifications • reputed company Certification in Psychiatry • reputed company and reputed company state medical license without encumbrances, and ability to obtain other state licenses. Preferred Qualifications • Minimum 5 years of clinical reputed company experience in the health care delivery field as a psychiatrist. • Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. • Child/Adolescent reputed company Certification Education MD or DO Pay reputed company The typical pay reputed company for this role is: $174,070.00 - $374,920.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in reputed company’s equity award program. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include: • reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. For more information, visit https://jobs.reputed company.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 02/13/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job