Remote Behavioral Medical Director

Role Overview: A clinical professional responsible for leading medical management, quality improvement, and credentialing activities within a health services team. Key Responsibilities: Assist the Chief Medical Director in directing utilization management, cost containment, and quality initiatives. Provide medical leadership for complex reviews, quality assurance, and ensuring timely, quality decision-making. Support performance improvement efforts for capitated providers and establish goals to enhance care quality and cost-efficiency. Participate in physician committees, conduct high-risk patient rounds, and collaborate with clinical teams and providers. Review claims for complex or controversial services, and develop provider alliances to improve utilization and quality. Identify clinical improvement opportunities, evaluate adverse trends, and facilitate implementation of clinical recommendations. Represent the organization on medical policies at state and national levels as needed. Qualifications & Skills: Medical Doctor or Doctor of Osteopathy with active medical practice. Board certification by the American Board of Psychiatry and Neurology; Child Psychiatry certification preferred. Experience in utilization management, quality standards, and working with diverse populations is advantageous. Knowledge of healthcare administration, insurance, or personnel management is a plus. Current unrestricted state medical license. #J-18808-Ljbffr