Medical Director - Behavioral Health
Core
Provide psychiatric leadership and physician oversight for a utilization management team, managing high-risk cases, medical necessity decisions, and clinical quality improvement for behavioral health care.
Role type
Senior Medical Director (Behavioral Health)
Builds
Utilization management programs and clinical quality improvement initiatives
Domain
Health Insurance / Behavioral Health
Required skills
Board-certified Psychiatrist, State medical license, Clinical practice experience, Managed care experience, Utilization review, Physician oversight, Appeals process management, Clinical policy development, Quality improvement, Triage and referral
Preferred skills
Texas residency, Child/Adolescent Board Certification, 5+ years clinical experience
Technologies
None stated
Responsibilities
Provide leadership and day-to-day physician oversight for utilization management team, Manage high-risk cases and medical necessity decisions, Participate in appeals process and investigate adverse events, Provide psychiatric leadership and training to interdisciplinary team, Develop and implement medical policies and clinical practice guidelines, Confer with practitioners on complex/treatment-resistant illnesses, Provide weekend coverage every 6-7 weeks
Seniority
Senior, hands-on IC