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, clinical quality improvement initiatives, and medical policies for a national health insurer.
Domain
Health Insurance / Behavioral Health
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Board-certified Psychiatrist, State medical licensure, Clinical practice experience, Managed care experience, Utilization review expertise, Medical policy development, Quality improvement leadership, Interdisciplinary team leadership
Preferred skills
Child/Adolescent Board Certification, Ohio residency, Multi-state licensure capability
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 evaluate utilization management programs and medical policies, Confer with practitioners on complex treatment-resistant illnesses, Provide weekend coverage every 6-7 weeks
Seniority
Senior, hands-on IC with strategic oversight