Medical Director, Behavioral Health (TX / WA)

JOB DESCRIPTION

Job Summary

Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical dependency services and assists with implementing integrated Behavioral Health care management programs.

Knowledge / Skills / Abilities

Provides Psychiatric leadership for utilization management and case management programs for mental health and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management policies and procedures to improve quality outcomes and decrease costs.

Provide regional medical necessity reviews and cross coverage

Standardizes UM practices and quality and financial goals across all LOBs

Responds to BH-related RFP sections and review BH portions of state contracts

Assist the BH MD lead trainers in the development of enterprise-wide teaching on psychiatric diagnoses and treatment

Provides second level BH clinical reviews, BH peer reviews and appeals

Supports BH committees for quality compliance.

Implements clinical practice guidelines and medical necessity review criteria

Tracks all clinical programs for BH quality compliance with NCQA and CMS

Assists with the recruitment and orientation of new Psychiatric MDs

Ensures all BH programs and policies are in line with industry standards and best practices

Assists with new program implementation and supports the health plan in-source BH services

Additional duties as assigned

Job Qualifications

REQUIRED EDUCATION :

• Doctorate Degree in Medicine (MD or DO) with Board Certification in Psychiatry

REQUIRED EXPERIENCE :

Required License, Certification, Association

Active and unrestricted State (TX) Medical License, free of sanctions from Medicaid or Medicare.

Preferred Experience

To all current Molina employees : If you are interested in applying for this position, please apply through the intranet job listing.

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

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