Psychiatry Medical Director: Utilization & Policy Leadership

Confidential; United States; Remote; USD 180,000 - 240,000; Full time

Job summary

Confidential is seeking a clinical leader to oversee utilization management, including medical necessity reviews and prior authorization decisions. You will lead initiatives to ensure appropriate care and consistent decision-making across medical policies.

You will engage in peer-to-peer discussions with practitioners to explain clinical rationales and explore alternative care options, and collaborate cross-functionally to improve processes, develop medical policies, and participate in quality

Qualifications

• Provide clinical leadership in utilization management, including medical necessity reviews and prior authorization decisions.

Responsibilities

• Provide clinical leadership in utilization management, including medical necessity reviews and prior authorization decisions.
• Engage in peer-to-peer discussions with practitioners to explain clinical rationales and explore alternative care options.
• Collaborate cross-functionally to improve utilization management processes, develop medical policies, and participate in quality improvement initiatives.

Job description

Confidential is seeking a clinical leader to oversee utilization management, including medical necessity reviews and prior authorization decisions. You will lead initiatives to ensure appropriate care and consistent decision-making across medical policies.

You will engage in peer-to-peer discussions with practitioners to explain clinical rationales and explore alternative care options, and collaborate cross-functionally to improve processes, develop medical policies, and participate in quality