Behavioral Health Medical Director – Psychiatrist - Louisiana Market
Core
Medical Director leading utilization management, clinical reviews, and quality initiatives for a behavioral health Medicaid program.
Role type
Director-level licensed physician (Psychiatrist)
Builds
Utilization management decisions and clinical quality programs for Medicaid members
Domain
US Healthcare / Behavioral Health / Medicaid
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Utilization management, peer-to-peer clinical reviews, medical policy interpretation, clinical guidelines development, program leadership, quality improvement, stakeholder consultation
Preferred skills
Child and Adolescent board certification, Applied Behavior Analysis (ABA) experience
Technologies
None stated
Responsibilities
Collaborate with care management teams to determine medical necessity, conduct peer-to-peer clinical reviews and appeals, interpret and develop medical policies, lead clinical and non-clinical activities impacting quality and cost, serve as a resource for other areas, represent the company to external entities
Seniority
Director, strategic leadership & operational oversight