Director of Behavioral Health

Job Summary

Join Molina's Behavioral Health team and lead the way in providing high-quality utilization management and case management programs for mental health and chemical dependency services. Help us implement integrated Behavioral Health care management programs that make a difference in the community.

Knowledge / Skills / Abilities

• Provide strong psychiatric leadership for utilization management and case management programs focused on mental health and chemical dependency. Collaborate with Regional Medical Directors to standardize utilization management policies and procedures aimed at improving quality outcomes while reducing costs.
• Conduct regional medical necessity reviews and provide cross-coverage as necessary.
• Standardize utilization management practices and align quality and financial goals across all Lines of Business (LOBs).
• Engage in reviewing Behavioral Health-related RFP sections and assess Behavioral Health portions of state contracts.
• Assist lead trainers in developing enterprise-wide education on psychiatric diagnoses and treatment.
• Conduct second-level Behavioral Health clinical reviews, peer reviews, and appeals.
• Support Behavioral Health committees in maintaining quality compliance.
• Implement clinical practice guidelines and medical necessity review criteria to ensure best practices are followed.
• Monitor all clinical programs for Behavioral Health quality compliance with NCQA and CMS standards.
• Contribute to the recruitment and orientation processes for new Psychiatric MDs.
• Ensure all Behavioral Health programs and policies align with industry standards and best practices.
• Assist with new program implementations and support the health plan's in-source Behavioral Health services.
• Perform 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