About this role
Role Overview
- Manages a team of Behavioral Health Medical Directors who primarily conduct Behavioral Health case reviews
- Provides medical interpretation and decisions about the appropriateness of services
- Participates in required state Behavioral Health administrative activities
- Oversees and helps to implement the Behavioral Health IRR process
- Conducts discussions with external physicians to gather additional clinical information
Requirements
- Doctor of Medicine (MD) or Doctor of Osteopathy (DO)
- Board-certified in Psychiatry (ABPN)
- An active and unrestricted license in at least one jurisdiction and willing to obtain a license, as required, for various states in region of assignment
- At least five years of experience post-residency/internship providing clinical services
- 2+ years of management experience
- Experience in utilization management review and case management in a health plan setting
- Experience with evidence-based guidelines utilized in assisting with determinations (e.g. MCG)
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance and many other opportunities