Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
This is a remote-based (work from home) role, preferably for candidates residing in Ohio.
As Medical Director (Behavioral Health), you will provide leadership and day-to-day physician oversight for the utilization management team, including managing high-risk cases and medical necessity decisions.
Key responsibilities:
- Provide comprehensive behavioral health care management to ensure quality care and improve program efficiency
- Participate in the appeals process, investigating adverse events and quality of care concerns
- Offer psychiatric leadership to an interdisciplinary utilization management team
- Assist with developing, implementing, and evaluating the utilization management program
- Collaborate with behavioral health practitioners regarding patient care
- Identify and address quality of care concerns with providers
- Provide psychiatric leadership for clinical quality improvement activities
- Participate in triage and referral for care management
- Provide weekend coverage every 6-7 weeks
Required qualifications:
- Board-certified Psychiatrist, currently licensed in Ohio or able to obtain licensure
- Active state medical license without encumbrances
- Ability to obtain additional state licensures for UM coverage across multiple state health plans
Preferred qualifications:
- Reside in Ohio
- Minimum 5 years of clinical practice experience as a psychiatrist
- Experience with managed care, utilization review, or physician advisor experience
- Child/Adolescent Board Certification
The typical pay range for this role is: $174,070.00 - $374,920.00 per year.
We offer a comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, and wellness programs.