Remote Behavioral Health Medical Director – Part-Time

Cambia Health; Yakima (WA); A distancia; USD 137.000 - 223.000; A tiempo parcial

Descripción de la vacante

Cambia Health is hiring an Associate Medical Director Behavioral Health or Utilization Management Medical Director. This part-time, remote role supports BH utilization management across states and requires an MD/DO with board certification in psychiatry and a valid license.

Responsibilities include leading BH reviews, developing policies, overseeing program operations, and advising staff. Preference for candidates in ID/UT; travel may be required.

Formación

• Licensed Physician with an MD or DO degree
• Active, unrestricted license to practice medicine in one or more of our 4 states.
• Board Certification in general psychiatry or child psychiatry required with preference for being board certified in both.
• Qualification by training and experience to render clinical opinions about medical conditions, procedures, and treatments under review.
• At least 3 years clinical experience.
• Two years health plan medical utilization management and/or case management experience.
• Equivalent combination of education and experience.
• Must be located in one of our four states.

Responsabilidades

• Completes Behavioral Health utilization management reviews, including PA, appeals and post-service.
• Develops and Implements Behavioral Health Policies and Programs: Assists in developing high-quality, market-competitive behavioral health medical policies and programs, and provides leadership in developing short and long-range plans, goals, and objectives for integrated utilization management.
• Operational Leadership and Oversight: Oversees the development of effective operational policies, procedures, and standards for an integrated behavioral health program, monitors utilization and results, and implements process or system changes as needed.
• Subject Matter Expert and Clinical Leadership: Serves as a subject matter expert on behavioral health, provides medical advice, oversight, and leadership for staff, and ensures members receive safe, effective, and cost-efficient services.
• Collaboration and Communication: Collaborates with the Executive Medical Director of Behavioral Health, leads/participates in teams for medical policy reviews and development, and discusses review determinations with providers to promote understanding of utilization management and quality improvement policies.
• Industry Trends and Opportunities: Stays abreast of industry, medical, and technology trends, identifies and communicates new opportunities to enhance outcomes and the organization's reputation, and collaborates to implement actions to reduce medical cost trend.
• Other roles as assigned.

Conocimientos

Behavioral health knowledge

Leadership experience

Communication skills

Clinical collaboration

Educación

MD or DO degree

Medical license (unrestricted)

Board certification in psychiatry

Herramientas

AI tools

Descripción del empleo

Cambia Health is hiring an Associate Medical Director Behavioral Health or Utilization Management Medical Director. This part-time, remote role supports BH utilization management across states and requires an MD/DO with board certification in psychiatry and a valid license.

Responsibilities include leading BH reviews, developing policies, overseeing program operations, and advising staff. Preference for candidates in ID/UT; travel may be required.