Medical Director, Behavioral Health (TX / WA) (Salt Lake City)

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 standardize 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 :

Required Experience :

Required License, Certification, Association :

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