Remote Part-Time Medical Director, Behavioral Health UM

Cambia Health; Salem (OR); In loco; USD 218.000 - 333.000; Part-time

Vantaggi offerti da questo lavoro

Work from home options

Descrizione del lavoro

Cambia Health is seeking an Associate Medical Director Behavioral Health or Utilization Management Medical Director to provide leadership and clinical oversight for behavioral health across all lines of business. This is a part-time, non-benefited role with a maximum of 12 hours per week, remote within Oregon, Washington, Idaho or Utah.

The role emphasizes utilization management, policy development, peer consultations, and collaboration with executives.

Competenze

• Licensed physician with an MD or DO degree.
• Active, unrestricted medical license in one of four states.
• Board certification in general or child psychiatry; dual board preferred.
• At least 3 years clinical experience.
• Two years health plan medical utilization management and/or case management experience.

Mansioni

• Completes Behavioral Health utilization management reviews (PA, appeals, 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.

Conoscenze

Leadership experience

Strong communication skills

Experience in utilization management

Ability to lead cross-functional teams

Formazione

MD or DO degree

Board Certification in general psychiatry or child psychiatry

Strumenti

AI tools

Descrizione del lavoro

Cambia Health is seeking an Associate Medical Director Behavioral Health or Utilization Management Medical Director to provide leadership and clinical oversight for behavioral health across all lines of business. This is a part-time, non-benefited role with a maximum of 12 hours per week, remote within Oregon, Washington, Idaho or Utah.

The role emphasizes utilization management, policy development, peer consultations, and collaboration with executives.