Medical Director – Psychiatrist, Child Adolescence

Role Overview

• Supports clinicians to ensure timely and consistent responses to members and providers
• Provides guidance for clinical operational aspects of a program
• Conducts peer-to-peer clinical reviews with attending physicians or other providers to discuss review determinations
• Serves as a resource and consultant to other areas of the company
• Interprets medical policies and clinical guidelines
• Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes
• Identifies and develops opportunities for innovation to increase effectiveness and quality

Requirements

• Requires MD or DO and Board certification
• Must possess an active unrestricted medical license to practice medicine
• Minimum of 10 years of clinical experience
• For Health Solutions and Carelon organizations, minimum of 5 years of experience providing health care is required
• Experience working in managed care environment strongly preferred
• 2-3 years utilization management review experience strongly preferred
• Clinical experience working with child adolescent or ABA cases strongly preferred
• Knowledgeable of Medicaid/Medicare policies and guidelines aligned to the state of Florida strongly preferred

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical, dental, vision, short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources