Talent.com
Medical Director, Behavioral Health
Medical Director, Behavioral HealthMolina Healthcare • Madison, WI, United States
[error_messages.no_longer_accepting]
Medical Director, Behavioral Health

Medical Director, Behavioral Health

Molina Healthcare • Madison, WI, United States
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

JOB DESCRIPTION Job SummaryProvides 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 Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification.

    • #PJHS

    #LI-AC1

    #HTF

    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.
    • [job_alerts.create_a_job]

    Director Behavioral Health • Madison, WI, United States

    [internal_linking.similar_jobs]
    Field Medical Director- (MD / DO)

    Field Medical Director- (MD / DO)

    Evolent • Madison, WI, United States
    [job_card.full_time]
    Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Physician Medical Director

    Physician Medical Director

    The Judge Group • Madison, WI, US
    [job_card.full_time]
    Physician Medical Director – Madison, WI (East Side).Madison, WI (East Side) location.Occupational Medicine and / or Urgent Care. Occupational Medicine are encouraged to apply.The Medical Director sup...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Medical Director Physician

    Medical Director Physician

    FCS, Inc. • Madison, IN, USA
    [job_card.full_time]
    Medical Director Physician at FCS, Inc.The Medical Director Physician oversees psychiatric care at an adult inpatient facility, ensuring high-quality treatment and leadership.This role requires an ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Locum Physician (MD / DO) - Family Practice in Wausau, WI

    Locum Physician (MD / DO) - Family Practice in Wausau, WI

    LocumJobsOnline • Madison, US
    [job_card.full_time]
    Doctor of Medicine | Family Practice.Competitive weekly pay (inquire for details) .LocumJobsOnline is working with Weatherby Healthcare to find a qualified Family Practice MD in Wausau, Wisconsin, ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Medical Director (MD or DO)- Madison, WI- Base Salary up to $250K / Year

    Medical Director (MD or DO)- Madison, WI- Base Salary up to $250K / Year

    Nova Medical Centers. • Madison, WI, US
    [job_card.full_time]
    NOVA MEDICAL CENTERS successfully operates outpatient acute injury care clinics in an Occupational Medicine setting.Services include minor work injury care, NO chronic pain management!Fully integra...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director of Clinical Reimbursement

    Director of Clinical Reimbursement

    Illuminus • Madison, WI, US
    [job_card.full_time]
    The Director of Clinical Reimbursement oversees the accurate and timely completion of the Minimum Data Set (MDS) by leading and supporting a team of Clinical Reimbursement Specialists.This role spa...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Locum Physician (MD / DO) - Pathology in Milwaukee, WI

    Locum Physician (MD / DO) - Pathology in Milwaukee, WI

    LocumJobsOnline • Madison, US
    [job_card.full_time] +1
    Doctor of Medicine | Pathology.Competitive weekly pay (inquire for details) .LocumJobsOnline is working with Wellhart, LLC to find a qualified Pathology MD in Milwaukee, Wisconsin, 53295!.We are se...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Associate Medical Director (AMD) – Wisconsin Region (.1 FTE)

    Associate Medical Director (AMD) – Wisconsin Region (.1 FTE)

    SSM Health • Madison, US
    [job_card.full_time]
    SSM Health is an Equal Opportunity Employer : .SSM Health is seeking a physician leader to serve as Associate Medical Director (AMD) for the Wisconsin region. FTE leadership role is designed to comple...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Medical Director

    Medical Director

    Wisconsin Community Veterinary Center • Madison, Wisconsin, United States
    [job_card.full_time]
    Medical Director - $160,000 - $170,000 plus Benefits Join a mission-driven team making veterinary care accessible to all. The Wisconsin Community Veterinary Center (WCVC) is a full-service, nonprofi...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Field Medical Director, Interventional Cardiology (Remote)

    Field Medical Director, Interventional Cardiology (Remote)

    Evolent • Madison, WI, United States
    [filters.remote]
    [job_card.full_time] +1
    Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Director of Case Management

    Director of Case Management

    Pivotal Placement Services • Madison, WI, US
    [job_card.full_time] +1
    [filters_job_card.quick_apply]
    This is a full time permanent opportunity with a national hospital system.We are looking for highly skilled, self-motivated, registered nurse (RN) who has leadership experience within an acute care...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Director / Director, Medical Science Liaison - Oncology, Central Region (Field-based)

    Associate Director / Director, Medical Science Liaison - Oncology, Central Region (Field-based)

    Eisai • Madison, WI, United States
    [job_card.full_time]
    At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission.We're a growing pharm...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director - Interventional Radiology Technologist

    Director - Interventional Radiology Technologist

    UW Health • Madison, WI, US
    [job_card.full_time]
    UW Health is seeking a Interventional Radiology Technologist Director for a job in MADISON, Wisconsin.Job Description & Requirements. Interventional Radiology Technologist.This is a full-time, p...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Occupational Medicine Physician

    Occupational Medicine Physician

    KPG Provider Services • Madison, Wisconsin, US
    [job_card.full_time] +1
    Occupational Medicine physician employment in Wisconsin : Inpatient Facility : Looking for an experienced Medical Director Occupational Medicine in the Madison, Wisconsin area.Below you will find ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Chief Psychiatrist - Behavioral Health Medical Director

    Chief Psychiatrist - Behavioral Health Medical Director

    Humana • Madison, WI, United States
    [job_card.full_time]
    Become a part of our caring community and help us put health first.The Chief Psychiatrist oversees our behavioral health (BH) clinical program for our Illinois FIDE members.The individual in this r...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Medical Director (MD or DO)- Madison, WI- Base Salary up to $300K / Year

    Medical Director (MD or DO)- Madison, WI- Base Salary up to $300K / Year

    Nova Medical Centers. • Madison, Wisconsin, United States
    [job_card.permanent]
    NOVA MEDICAL CENTERS successfully operates outpatient acute injury care clinics in an Occupational Medicine setting.Services include minor work injury care, NO chronic pain management!Fully integra...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Director of Case Management

    Director of Case Management

    Pivotal Placement Services, Inc • Madison, WI, US
    [job_card.full_time] +1
    This is a full-time permanent opportunity with a national hospital system.Are you ready to take your case management expertise to the next level? This is your opportunity to lead a dynamic team and...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    OB-GYN Medical Director Opportunity in Madison, Wisconsin

    OB-GYN Medical Director Opportunity in Madison, Wisconsin

    CHG Healthcare • Madison, WI, US
    [job_card.permanent]
    This Wisconsin city consistently ranks as one of the top places in the country to live, work, go to school, play, and raise a family. The city was recently named as the most livable mid-size city in...[show_more]
    [last_updated.last_updated_30] • [promoted]