Medical Director - Behavioral Health - ABH OH
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 for health plans.
Domain
Health Insurance / Behavioral Health
Required skills
Board-certified Psychiatry, State Medical License, Utilization Management, Clinical Quality Improvement, Medical Policy Development, High-Risk Case Management, Interdisciplinary Leadership
Preferred skills
Managed Care Experience, Physician Advisor Experience, Child/Adolescent Board Certification, 5+ years Clinical Practice
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 with leadership responsibilities