Medical Director, Behavioral Health (TX / WA)
Molina HealthcareRochester, MI, United States- Full-time
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.
#PJHS
#LI-AC1
Pay Range : $161,914.25 - $315,733 / ANNUAL
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