Medical Director

Lucet; United States; Remote; USD 270,000 - 310,000; Full time

Job summary

An established industry player in behavioral health is seeking a dedicated Medical Director to lead clinical programs and improve patient outcomes. This role offers the chance to make a significant impact on the lives of over 15 million people across the U.S. You will oversee medical management activities, ensure compliance with regulations, and collaborate with providers to enhance care. With a focus on professional development and a commitment to diversity, this position is perfect for someone passionate about making a difference in the healthcare landscape. Join a team where your leadership can truly shine!

Benefits

Health Insurance

401(k) with Employer Match

Paid Time Off

Tuition Reimbursement

Company Paid Life and Disability Insurance

Qualifications

• Medical Degree with active, unrestricted license; board certified in psychiatry.
• 3+ years in managed care or utilization management; 5+ years as a practicing psychiatrist.

Responsibilities

• Oversee clinical programs including Utilization Management and Case Management.
• Conduct medical necessity reviews and manage medical outcomes.

Skills

Analytical Skills

Problem-Solving Skills

Communication Skills

Leadership Skills

Knowledge of Managed Care

Education

Medical Degree

Board Certification in Psychiatry

Job description

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Who We Are
At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our purpose is to advocate for and improve the overall well-being of those we serve, through balanced treatment of the mind and body.

When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives.

Why join our team at Lucet?
We are a team of collaborative and hard-working professionals working to improve behavioral health outcomes in a fast-paced and changing environment. No two days are the same. If you find joy in meaningful work and delivering excellent results, we encourage you to apply!

Benefits
We offer top-tier compensation and benefits, including:

• Annual compensation between $270,000 - $310,000, PLUS an annual performance-based, discretionary incentive. Compensation depends on skills, education, experience, and market data.
• Health Insurance – $0 premium for employee-only coverage in our core program for participants in our Wellbeing Incentive Program.
• 401(k) with competitive employer match
• Company paid life and disability insurance, wellbeing incentives, and parental leave
• Professional development opportunities and tuition reimbursement
• Paid time off including volunteer leave
• Opportunities for personal and professional growth, welcoming diverse backgrounds and experiences.

What You Will Do - Essential Functions
The Medical Director provides oversight of clinical programs including Utilization Management, Disease Management, Pharmacy Management, and Case Management. Responsibilities include medical necessity reviews, peer reviews, and appeals. The role manages medical outcomes and expense initiatives, overseeing medical/peer review activities.

• Clinical Leadership and Management:
  • Serve as Medical Director for assigned health plans, ensuring compliance.
  • Oversee medical management activities.
  • Educate clinical teams to improve decision-making and patient outcomes.
  • Consult with providers to enhance decision-making and cost-effective care.
  • Conduct market research to inform service development.
• Compliance and Quality Improvement:
  • Identify opportunities to improve outcomes and manage expenses.
  • Evaluate new technologies and treatments for best practices and cost-effectiveness.
  • Ensure adherence to accreditation and regulatory standards.
  • Conduct appeal reviews, including peer-to-peer evaluations.
  • Support Independent Review Organizations in case outcomes.
• Cross-functional and Provider Collaboration:
  • Align medical management with provider relationships and access standards.
  • Maintain positive relationships with stakeholders.

Who You Are

• Required Qualifications:
  • Medical Degree with active, unrestricted license; ability to obtain licenses in other states.
  • Board certified in psychiatry and/or child or adolescent psychiatry.
  • 3+ years in managed care or utilization management.
  • 5+ years as a practicing psychiatrist.
  • 1+ years of clinical leadership experience.
  • Engaged in the medical community.
  • Proven leadership in clinical initiatives and strategic planning.
  • Knowledge of managed care, regulations, and compliance in behavioral health.
  • Ability to pass background checks and screenings.
• We value qualities like compassion, adaptability, growth-mindedness, and respect for diversity.
• Competencies:
  • Strong analytical and problem-solving skills.
  • Excellent communication and collaboration skills.
  • Leadership and motivation abilities.
  • High integrity and ethical standards.
  • Ability to identify compliance issues.
• Working Conditions:
  • Remote work with company equipment.
  • Quiet workspace with high-speed internet (minimum 20 Mbps download, 5 Mbps upload).
  • Sitting for long periods, typing required.

We welcome diverse applicants who meet these qualifications.