Director of Behavioral Health Services

Job Summary

Join Molina's Behavioral Health team to lead and provide guidance in our utilization and case management programs for mental health and chemical dependency services. Be at the forefront of implementing integrated Behavioral Health care management programs that make a difference in the lives of our members.

Knowledge / Skills / Abilities

As a key Psychiatric leader, you will oversee utilization management and case management initiatives, collaborating with Regional Medical Directors to standardize policies and improve outcomes. Your role includes :

• Conducting regional medical necessity reviews and providing coverage support.
• Standardizing utilization management practices to align with quality and financial objectives across all lines of business.
• Responding to behavioral health-related RFP sections and reviewing state contract components.
• Collaborating with Behavioral Health MD lead trainers to develop educational resources on psychiatric diagnoses and treatments.
• Providing second-level clinical reviews, peer reviews, and handling appeals.
• Supporting Behavioral Health committees to ensure quality compliance.
• Implementing clinical practice guidelines and medical necessity review criteria.
• Tracking clinical programs for Behavioral Health quality compliance with NCQA and CMS standards.
• Assisting with the recruitment and orientation of new Psychiatric MDs.
• Ensuring all BH programs and policies align with industry standards and best practices.
• Helping with the implementation of new programs and supporting the health plan in sourcing Behavioral Health services.
• Additional duties as assigned.

Job Qualifications

REQUIRED EDUCATION :

REQUIRED EXPERIENCE :

Required License, Certification, Association

PREFERRED EXPERIENCE

If you are a current Molina employee and interested in this opportunity, please apply through our internal job listing.

Molina Healthcare provides a competitive benefits and compensation package. We are proud to be an Equal Opportunity Employer (EOE) M / F / D / V.

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