Remote Behavioral Medical Director

About the Role

A clinical professional responsible for leading medical management, quality improvement, and credentialing activities within a health services team.

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

• Medical Doctor or Doctor of Osteopathy with active medical practice.
• Board certification by the American Board of Psychiatry and Neurology; Child Psychiatry certification preferred.
• Current unrestricted state medical license.

Skills

• Experience in utilization management, quality standards, and working with diverse populations is advantageous.
• Knowledge of healthcare administration, insurance, or personnel management is a plus.