Behavioral Health Medical Director- Psychiatrist - Part-time

Behavioral Health Medical Director- Psychiatrist - Part-time

Location: Virtual-This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered.

Schedule: Part-time 10 hours a week.

The Behavioral Health Medical Director oversees the administration of behavioral health services to ensure members receive appropriate, high-quality, and cost-effective care. This role provides clinical consultation and strategic guidance to strengthen clinical operations, supports the design and implementation of initiatives that improve quality, outcomes, and affordability, and identifies cost-of-care opportunities. The Medical Director also serves as a clinical resource to staff, including Medical Director Associates, and may have accountability for an entire clinical program.

We are seeking a psychiatrist for this position to complement and expand the capabilities of our behavioral health team, working alongside an existing PhD psychologist medical reviewer. The role will part-time and will initially work 10 hours per week, with some weekend coverage as needed.

Primary duties may include, but are not limited to:

• 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, and patients office visits with providers and external physicians.
• Serves as a resource and consultant to other areas of the company.
• Represent the company to external entities and/or serve on internal and/or external committees.
• Chair company committees. Interprets medical policies and clinical guidelines.
• Develops and proposes new medical policies based on changes in healthcare.
• 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.
• The Medical Director typically has program management responsibilities including clinical policy development, program development/implementation, and overseeing clinical/non-clinical activities.
• Attendance at Behavioral Health interdisciplinary team (IDT) meetings.
• Attend and participate in other team-related meetings with regularity (monthly, quarterly)

Requirements

• MD/DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA). Must possess an active unrestricted medical license to practice medicine or a health profession.
• Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US.
• Additional experience may be required by State contracts or regulations if the Medical Director is filing a role required by a state agency.
• For Health Solutions and Carelon organizations (including behavioral health) only, minimum of 5 years of experience providing health care is required.
• Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.

Additional Information:

• Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
• Current VT, DE, WY, AR, MS, NM license or willingness to apply for licensing in these states if needed.
• Utilization Management experience.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $68,156 to $106,881

Location(s): Illinois, Massachusetts, New Jersey