Psychiatrist - Behavioral Health (BH) Medical Director

Spectrum Healthcare Resources; Portland (OR); On-site; USD 150,000 - 210,000; Full time

Job summary

An established industry player is seeking a Behavioral Health Medical Director to enhance the integration of behavioral health services within a military healthcare program. This pivotal role involves providing expert guidance on clinical practices, ensuring high-quality care for military personnel and their families. The ideal candidate will leverage extensive experience in clinical practice and medical management to drive improvements in service delivery and patient outcomes. Join a mission-driven organization that values excellence and innovation in healthcare, and make a significant impact on the lives of those who serve our country.

Qualifications

• 5+ years of clinical practice experience required.
• 3+ years of medical management experience in Managed Care.
• Board Eligible or Board Certified in Psychiatry.

Responsibilities

• Make timely BH coverage determinations per government contracts.
• Provide expertise to clinical staff in network and medical management.
• Advise leadership on BH best practices for beneficiary well-being.

Skills

Clinical Practice

Medical Management

Utilization Management

Quality Management

Case Management

Disease Management

Psychiatry Expertise

Education

Medical Doctor Degree

Board Certification in Psychiatry

Advanced Degree in Public Health or Business

Tools

InterQual

Job description

Job Description

Job SummaryThe Spectrum Healthcare Resources Behavioral Health (BH) Medical Director assists in integrating BH into the TriWest program and their processes; maintaining a BH network that is highly reliable, high quality, and educated in the delivery of healthcare services to those who are serving or have served in the military and their dependents. The BH Medical Director functions as a BH subject matter expert to TriWest leadership and medical management staff. They consult directly with TriWest staff on Behavioral Health issues and assist in strategic initiatives to improve the safety and efficiency of the delivery of care through the network primarily via actions in utilization management, case management, quality oversight, and other medical management roles. They support TriWest’s mission, values, and goals, ensuring they meet or exceed contractual and program standards. Using independent problem-solving skills, they help resolve concerns throughout the healthcare experience. Reports to the TriWest Behavioral Health Chief Medical Officer (CMO).

Education & Experience

Required

• Medical Doctor Degree
• U.S. Citizenship
• Ability to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation for public trust
• Current unrestricted license to practice medicine in a state or territory of the United States (CA and WA preferred)
• Board Eligible or preferably Board Certified in Psychiatry
• 5+ years clinical practice experience
• 3+ years medical management experience in a Managed Care environment
• Experience with utilization Management, Quality Management, Case Management, and/or Disease Management

Preferred

• Advanced degree in public health or business
• Government Healthcare experience
• Experience using InterQual and/or similar evidence-based criteria to assess medical interventions, procedures, and treatments

Key Responsibilities

• Makes timely accurate BH coverage determinations in accordance with government contracts using objective evidence and clinical practice guidelines. Responds within contract requirements to reconsideration and appeal requests, including peer-to-peer discussions where requested.
• Provides subject matter expertise to the clinical staff at all levels of care in the network and in TriWest’s medical management plans. Shares psychiatric expertise regarding transitions of care such as home care, discharge planning, case management, and disease management.
• Advises leadership of Utilization Management (UM), Clinical Quality Management (CQM), Case Management (CM), Disease Management (DM), Population Health (PH), and other TriWest staff on BH best practices for the coordination and advancement of beneficiary well-being. Supports medical management staff in conducting clinical case reviews and focused studies to evaluate safety and efficiency in the network. Performs medical necessity review and peer-to-peer discussions to facilitate timely delivery of care.

Contact:

Joseph Day - Senior Recruiter

Spectrum Healthcare Resources, 12647 Olive Blvd, Suite 600, St. Louis, MO 63141

Toll-Free: 1-800-325-3982 ext. 54138

Direct: 314-744-4138

www.spectrumhealth.com

Company Overview:

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization providing physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics, and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, serving 860 civilian and military hospitals with a team of 9,800 healthcare professionals.

Spectrum Healthcare Resources is an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Location

US-OR-Portland

Recruiter

Full Name: Joseph Day

Direct Phone Number

314-744-4138

Recruiter Email

[e-mail]