Remote Psychiatric Medical Director - Utilization & Quality

CVS Health; Austin (TX); Teletrabalho; USD 174 000 - 375 000; Tempo integral

Resumo da oferta

CVS Health is seeking a Board-certified psychiatrist to lead and oversee utilization management, focusing on high-risk cases, medical necessity decisions, and behavioral health care management. You’ll guide interdisciplinary teams and contribute to policy development.

The role supports clinical quality improvement, QA investigations, and appeals, with weekend rotation and cross-state licensure capabilities. Texas license or eligibility is required.

Qualificações

• Board-certified psychiatrist with Texas license or eligibility to obtain Texas licensure.
• Experience in behavioral health manage care and utilization management.
• Experience with physician advisor roles and clinical policy interpretation.

Responsabilidades

• Provide leadership and day-to-day physician oversight for utilization management.
• Oversee high-risk cases and medical necessity decisions.
• Lead behavioral health care management to improve program efficiency.
• Participate in appeals process and quality concerns investigations.
• Provide psychiatric leadership to interdisciplinary utilization management team.
• Develop and interpret medical policies and clinical guidelines.
• Support triage and referral for care management.
• Provide weekend coverage every 6-7 weeks.

Conhecimentos

Leadership

Clinical oversight

Behavioral health care

Quality improvement

Formação académica

MD/DO (Doctor of Medicine / DO)

Descrição da oferta de emprego

CVS Health is seeking a Board-certified psychiatrist to lead and oversee utilization management, focusing on high-risk cases, medical necessity decisions, and behavioral health care management. You’ll guide interdisciplinary teams and contribute to policy development.

The role supports clinical quality improvement, QA investigations, and appeals, with weekend rotation and cross-state licensure capabilities. Texas license or eligibility is required.