Behavioral Health Medical Director - Psychiatrist - Louisiana Market

About the role

The Behavioral Health Medical Director focuses on utilization management within a behavioral health Medicaid program. Responsibilities include collaborating with care management teams, consulting with providers, and reviewing cases to determine medical necessity using established criteria. Work involves chart reviews, documentation, and peer-to-peer discussions when needed. Additional responsibilities may include participation in quality initiatives and other program-related projects.

Responsibilities

• Collaborates with care management teams
• Consults with providers
• Reviews cases to determine medical necessity
• Conducts peer-to-peer clinical reviews with attending physicians or other providers
• Conducts peer-to-peer clinical appeal case reviews
• Serves as a resource and consultant for other areas of the company
• Makes presentations to external entities and/or serves on internal and/or external committees
• Learns, develops, directs, and implements clinical and non-clinical activities
• Identifies and develops opportunities for innovation

Requirements

• MD or DO and Board certification approved by ABMS or AOA
• Active unrestricted medical license to practice medicine or a health profession
• Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
• Child and Adolescent board certification or meaningful experience preferred
• Ability to obtain a Louisiana medical license
• Background in applied behavior analysis (ABA) or openness to expanding into ABA work preferred

Qualifications

• MD or DO and Board certification approved by ABMS or AOA
• Active unrestricted medical license to practice medicine or a health profession
• Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
• Child and Adolescent board certification or meaningful experience preferred
• Ability to obtain a Louisiana medical license
• Background in applied behavior analysis (ABA) or openness to expanding into ABA work preferred

Skills

• Medical knowledge
• Collaboration skills
• Review and decision-making skills
• Communication skills
• Leadership skills
• Quality improvement skills

Benefits

• Market-competitive total rewards
• 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 and financial education resources

Pay

Commensurate with experience.

Schedule

Full-time, with the exception of required in-person training sessions.