Remote Behavioral Medical Director, Full-Time

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 coordinating utilization management, medical review, and quality initiatives to enhance care quality and cost-effectiveness.
• Conduct complex medical reviews and support performance improvement programs.
• Develop policies to optimize healthcare delivery.
• Lead provider network development and participate in external committees.
• Represent the organization on medical policies.
• Collaborate with clinical teams and providers to review complex cases and ensure appropriate utilization.
• Conduct high-risk patient rounds and facilitate provider education on clinical policies.
• Identify utilization trends and clinical improvement opportunities to reduce unwarranted practice variation.
• Review claims involving complex or new services for medical necessity and payment accuracy.
• May participate in provider education, represent the organization publicly, and support operational needs, including working weekends or holidays as necessary.

Requirements

• Medical Doctor or Doctor of Osteopathy.
• Board-certified in Psychiatry or related specialty preferred.
• Utilization management experience and knowledge of quality standards.
• Active medical practice required.
• Experience with diverse populations and familiarity with healthcare policies advantageous.

Skills

• Strong collaboration, communication, and leadership skills.

Benefits

• Competitive salary.
• Comprehensive benefits.
• Flexible work arrangements.