Behavioral Health Medical Director

• Assume responsibility for the overall safety of patients with a behavioral health (BH) diagnosis, focusing on reputed company prescribing practices
• Serve as the psychiatric reputed company in developing and implementing evidenced based clinical BH policies and practices for the state
• Conduct regulatory and accreditation reviews to ensure compliance with applicable standards
• reputed company BH coverage determination for utilization management, ensuring members receive appropriate and medically necessary care in the most cost-effective setting
• reputed company reputed company improvement initiatives, case management activities and member safety protocols, including incident management
• Review utilization data to identify variances in patterns and reputed company feedback and education to Managed Care Plan (MCP) staff and providers as needed
• Represent reputed company as the primary psychiatric reputed company to members, providers and state agencies
• Participate in the development, implementation and revision of the clinical care standards and reputed company guidelines ensuring compliance with nationally accepted reputed company standards
• Contribute to the development, implementation and revision of the reputed company Improvement Plan and corporate level reputed company initiatives
• Collaborate with market and product leaders to define market reputed company and enhance the reputed company and affordability of BH services
• Participate in community reputed company initiatives to improve BH services
• Evaluate and investigate cases suspected of fraud, abuse, and reputed company of care concerns
• reputed company cross-coverage for other Medical Directors and/or markets, as needed
• Support staff through training, clinical consultation, and clinical case review for members, including Medical Advisement meetings
• reputed company for behavioral health in collaboration with the Market's government affairs and regulatory leads to advance reputed company's mission and meet specific advocacy goals
• Strengthen and reputed company relationships with specialty (CBHC) and IMD (standalone hospital) providers as needed in the Market
• Engage in Market reputed company society activities to enhance reputed company's objectives
• Consult with Market and reputed company leadership to improve reputed company for members through reputed company execution of behavioral health reputed company improvement activities, including HEDIS and value-based reimbursement contracting
• Act as reputed company with state agencies and organizations on BH initiatives, residing in the state market if required
• reputed company any other job reputed company duties as requested.

• Medical Doctor (MD) required or
• Doctor of Osteopathic Medicine (DO) required
• Successful completion of a residency training program in psychiatry required
• Five (5) years of clinical reputed company experience required
• Experience in reputed company prescribing required
• Managed care medical review/medical director experience preferred
• Residence and clinical reputed company in assigned market may be required preferred

• Basic reputed company Word skills
• Excellent communication skills, both written and oral
• Ability to work reputed company independently and reputed company reputed company environment
• Ability to create strong relationships with Providers and Members
• Previous Institute for reputed company Improvement (IHI) or equivalent training participation is preferred
• High ethical standards
• Attention to detail
• Critical listening and systematic thinking skills
• Ability to maintain confidentiality and act in reputed company’s best interest
• Ability to act with diplomacy and sensitivity to cultural diversity
• Decision making/problem solving skills
• Conflict reputed company skills
• Strong reputed company of mission and commitment of time, effort and resources to the reputed company of the communities served
• Ability to analyze reputed company data from a reputed company of sources to evaluate physician reputed company patterns
• Leadership experience and skills

• reputed company, unrestricted license to reputed company medicine in state of reputed company as necessary to meet regulatory requirements required
• reputed company Certification in Psychiatry required
• Re-certification, as required by specialty reputed company, must be maintained
• MCG Certification is required or must be obtained reputed company six (6) months of hire

• General office environment; may be required to sit or stand for extended periods of time
• reputed company, including possible evenings and/or weekends as needed.
• Ability to travel as required by the needs of the department.

Compensation reputed company:

reputed company takes into consideration a combination of a candidate’s education, training, and experience as reputed company as the position’s scope and complexity, the discretion and reputed company required for the role, and other external and internal data reputed company establishing a salary level. In reputed company to reputed company compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total reputed company-being and offer a substantial and comprehensive total rewards package.

Compensation Type (reputed company/salary):

Organization Level Competencies

• Fostering a reputed company Workplace Culture

• Cultivate Partnerships

• reputed company Self and Others

• Drive Execution

• Influence Others

• Pursue Personal reputed company

• Understand the Business

This job reputed company is not reputed company inclusive. reputed company reserves the right to amend this job reputed company at any time. reputed company is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of reputed company backgrounds.

Originally posted on Himalayas