Behavioral Health Medical Director
Core
Develop behavioral health care strategy and operations, including procedures, productivity targets, and new delivery models while ensuring quality of care and financial goals.
Role type
Senior Medical Director (Behavioral Health)
Builds
Operational frameworks for behavioral health services and utilization management processes
Domain
Healthcare / Behavioral Health / Managed Care
Required skills
Medical decision-making, regulatory compliance, utilization management, data analysis, strategic planning, stakeholder communication
Preferred skills
Managed care industry knowledge, national clinical guidelines (MCG/InterQual), population health, business metrics, case management
Technologies
CMS policies, MCG, InterQual
Responsibilities
Authorize services and levels of care based on medical background and regulatory context; develop procedures and delivery models; analyze utilization patterns for pricing; collaborate with external physicians and community groups; operationalize Medicare/Medicaid requirements.
Seniority
Senior, hands-on IC with strategic oversight