Senior Medical Director – Behavioral Health

Molina Healthcare; Naples (FL); Hybrid; USD 186,000 - 363,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare seeks a Medical Director-level physician to oversee behavioral health and chemical dependency services, ensuring high quality care and cost effectiveness within targeted markets. You will guide utilization management, develop enterprise-wide education, and lead clinical reviews while aligning programs with NCQA and CMS standards.

The role requires MD/DO with board certification in Psychiatry (Child/Adolescent), plus 2+ years in psychiatry/behavioral health and strong leadership

Qualifications

• MD/DO degree required and active license to practice medicine.
• Board certification in Psychiatry (Child and Adolescent Psychiatry).
• Experience leading behavioral health and care management programs.
• Strong knowledge of regulatory requirements affecting medical staff.
• Excellent cross-functional collaboration and communication skills.

Responsibilities

• Provide medical oversight for behavioral health and chemical dependency services.
• Lead regional behavioral health utilization management and care programs.
• Standardize policies to improve quality and reduce costs.
• Manage regional medical necessity reviews and cross-coverage.
• Support enterprise-wide education on psychiatric diagnoses and treatments.
• Oversee clinical reviews, peer reviews, and appeals.
• Support quality compliance in behavioral health committees.
• Implement clinical guidelines and review criteria for medical necessity.
• Track programs for NCQA and CMS compliance.
• Assist recruitment and orientation of psychiatric medical directors.

Job description

Molina Healthcare seeks a Medical Director-level physician to oversee behavioral health and chemical dependency services, ensuring high quality care and cost effectiveness within targeted markets. You will guide utilization management, develop enterprise-wide education, and lead clinical reviews while aligning programs with NCQA and CMS standards.

The role requires MD/DO with board certification in Psychiatry (Child/Adolescent), plus 2+ years in psychiatry/behavioral health and strong leadership