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Medical Director, Behavioral Health (WA)
Medical Director, Behavioral Health (WA)Molina Healthcare • Dallas, TX, United States
Medical Director, Behavioral Health (WA)

Medical Director, Behavioral Health (WA)

Molina Healthcare • Dallas, TX, United States
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  • [job_card.full_time]
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Overview

JOB DESCRIPTION Provides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets / regions. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

  • Provides behavioral health oversight and clinical leadership for health plan and / or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs.
  • Facilitates behavioral health-related regional medical necessity reviews and cross coverage.
  • Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses.
  • Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts.
  • Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment.
  • Provides second level behavioral health clinical reviews, peer reviews and appeals.
  • Supports behavioral health committees for quality compliance.
  • Implements behavioral health specific clinical practice guidelines and medical necessity review criteria.
  • Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS).
  • Assists with the recruitment and orientation of new psychiatric medical directors.
  • Ensures all behavioral health programs and policies are in line with industry standards and best practices.
  • Assists with new program implementation and supports for health plan in-source behavioral health services.

Required Qualifications

  • At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry / behavioral health, or equivalent combination of relevant education and experience.
  • Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice.
  • Board Certification in Psychiatry.
  • Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.
  • Ability to work cross-collaboratively within a highly matrixed organization.
  • Strong organizational and time-management skills.
  • Ability to multi-task and meet deadlines.
  • Attention to detail.
  • Critical-thinking and active listening skills.
  • Decision-making and problem-solving skills.
  • Strong verbal and written communication skills.
  • Microsoft Office suite / applicable software program(s) proficiency, and ability to learn new programs.

    • Preferred Qualifications

  • Experience with utilization / quality program management.
  • Managed care experience.
  • Peer review experience.
  • Certified Professionals certifications : CPHM, CPHQ, CCMC, CMSA or other health care or management certification.

    • To all current Molina employees : If you are interested in applying for this position, please apply through the Internal Job Board.

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V

    Pay Range : $161,914.25 - $315,733 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.

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