Medical Director

Pacer Group; United States; Remote; Full time

Job summary

A leading healthcare provider is seeking a Medical Director specializing in Behavioral Health and Substance Abuse. This remote position requires clinical oversight and collaboration with medical management teams. The ideal candidate will have extensive experience in clinical practice and medical management, ensuring quality and effective behavioral healthcare solutions.

Qualifications

• 5+ years clinical practice experience required.
• 5+ years medical management experience in a Managed Care environment.

Responsibilities

• Provides clinical oversight to Behavioral Health activities.
• Consults directly with client’s staff on clinical Behavioral Health issues.
• Collaborates with medical management leadership on integrated practices.

Skills

Clinical Oversight

Behavioral Health

Medical Management

Consultation

Team Building

Critical Thinking

Education

Medical Doctor Degree

Board Certified in Psychiatry

Job description

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Base pay range

$110.00/hr - $120.00/hr

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Job Title: Medical Director (Behavioral Health And Substance Abuse)

Location: Remote

Duration: 7-8 Months

Shift: Must be able to support EST/CST hours

Job Summary

• Provides clinical oversight to directed BH activities throughout the West Region. Functions as the senior Behavioral Health clinical consultant for client’s medical management reporting to the client’s Behavioral Health Chief Medical Officer (CMO). Consults directly with client’s staff on clinical Behavioral Health issues.
• Government Reporting
• Indirect

Education & Experience

Required

• Medical Doctor Degree
• Current unrestricted license to practice medicine in a state or territory of the United States
• Board Certified in Psychiatry
• 5+ years clinical practice experience
• 5+ years medical management experience in a Managed Care environment
• Experience with utilization Management, Quality Management, Case Management, and Disease Management
• Preferred
• Advanced degree or certificate in medical management
• TRICARE or Government experience

Key Responsibilities

• Consults with practitioners in the field.
• Functions as the Behavioral Health clinical authority at client’s.
• Collaborates with CMOs, other medical directors, medical management leadership, and staff, on the development and implementation of integrated behavioral healthcare management practices.
• Acts as lead consultant to Sr. VP Medical Management & Chief Medical Officers, VP, and other senior staff on BH-related matters.
• Supports medical management staff in the conduct of clinical case reviews and focused studies and reviews.
• Conducts medical necessity review and is available for peer to peer discussions.
• Assists in physician-to-physician communications with BH clinicians related to practice pattern enhancement.
• Consults, advises, and provides clinical supervision to client’s clinical staff on Behavioral Health- related responsibilities.
• Provides direct support to Team Coordinators, Behavioral Health and other Medical Directors.
• Works with other Medical Directors on committees and projects to support client's Medical Management program.
• Works with BH clinical advisors and local BH advisory committees in the Service Areas.
• Advises Directors of Utilization Management (UM), Quality Management (QM), Case Management (CM), and Disease Management (DM) and staff on Behavioral Health matters.
• Provides clinical consultation to staff and oversight for decisions effecting beneficiaries.
• Chairs committees as required.
• Reviews Behavioral Health operations with management team to identify and implement quality and process improvements.

JOB DESCRIPTION

• This job description indicates the general nature and levels of work expected of the incumbents. It is not designed to cover or contain a comprehensive listing of activities, duties, responsibilities or competencies required of an incumbent. Incumbents may be asked to perform other duties as required.
• Consults with client’s staff on clinical decisions and reviews.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Technical Skills

• Knowledge of health care cost containment and continuous quality improvement, familiar with Child and Adolescent Psychiatric services, levels of care, and neuropsychiatric testing, knowledge of Managed Care practices, URAC standards and process, HIPPA regulations and requirements and Managed Behavioral Health care practices; ability to work in a matrix environment.
• Team building / Team Player
• Influence the actions and opinions of others in a positive direction and build group commitment.
• Independent Thinking / Self-Initiative
• Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Computer Literacy

• Ability to function in a multi-system Microsoft environment using Word, Outlook, client’s Intranet, the Internet, and department software applications.

Communication / People Skills

• Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Coaching / Training / Mentoring

• Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Working Conditions

• Availability to work non-regular hours as required
• Works in a standard office environment, with minimal travel
• Extensive computer work with prolonged sitting
• Department of Defense security clearance required

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care and Medical Practices

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