Medical Director, Behavioral Health

Molina Healthcare • Long Beach, CA • 2h ago

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs.

Facilitates behavioral health-related regional medical necessity reviews and cross coverage.

Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses.

Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts.

Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment.

Provides second level behavioral health clinical reviews, peer reviews and appeals.

Supports behavioral health committees for quality compliance.

Implements behavioral health specific clinical practice guidelines and medical necessity review criteria.

Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS).

Assists with the recruitment and orientation of new psychiatric medical directors.

Ensures all behavioral health programs and policies are in line with industry standards and best practices.

Assists with new program implementation and supports for health plan in-source behavioral health services.

Required Qualifications

At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience.

Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice.

Board Certification in Psychiatry.

Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.

Ability to work cross-collaboratively within a highly matrixed organization.

Strong organizational and time-management skills.

Ability to multi-task and meet deadlines.

Attention to detail.

Critical-thinking and active listening skills.

Decision-making and problem-solving skills.

Strong verbal and written communication skills.

Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.

Preferred Qualifications

Experience with utilization/quality program management.

Managed care experience.

Peer review experience.

Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $186,201.39 - $363,092.71 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Similar Jobs

Medical Director, Behavioral Health

Molina Healthcare • Los Angeles, CA • 2h ago

Hospital & Medical

2h ago

Go to Apply

Clinical Research Intern (part time) - CA Heart Foundation - Medical Network

Cedars-Sinai • Beverly Hills, CA • 2h ago

Hospital & Medical

Description The California Heart Center is an affiliate of the Cedars-Sinai Heart Institute, located in Beverly Hills, California, We offer the full spectrum of cardiology care, including, Cardiac Evaluation/Adult Cardio...

2h ago

Go to Apply

Heart Institute - Clinical Research Data Specialist I, Susan Cheng Team

Cedars-Sinai • Los Angeles, CA • 3h ago

Hospital & Medical

Job Description About Cedars-Sinai and Smidt Heart Institute Cedars-Sinai is a world-class academic medical center known for innovation, excellence in patient care, and groundbreaking research. The Smidt Heart Institute...

3h ago

Go to Apply

Laboratory Assistant II, West Los Angeles (On-call, Day shift)

Kaiser Permanente • Los Angeles, CA • 3h ago

Hospital & Medical

Job Summary: To perform venipuncture and skin puncture and pre-analytical and post analytical steps of laboratory testing. Essential Responsibilities: Upholds Kaiser Permanentes Policies and Procedures, Principles of Res...

3h ago

Go to Apply

Ambulatory Care Pharmacist

Kaiser Permanente • Downey, CA • 6h ago

Hospital & Medical

Job Summary: Provides ambulatory pharmaceutical care services using approved protocols in collaboration with other health professional, including managing patient drug therapy, providing patient education, and preparing...

6h ago

Go to Apply

Applied AI Health System Engineer - Senior Manager

PwC • Irvine, CA • 6h ago

Hospital & Medical

Specialty/Competency: Data, Analytics & AI Industry/Sector: Health Services Time Type: Full time Travel Requirements: Up to 80% At PwC, our people in data and analytics engineering focus on leveraging advanced techno...

6h ago

Go to Apply

Applied AI Health System Engineer - Senior Manager

PwC • Los Angeles, CA • 6h ago

Hospital & Medical

6h ago

Go to Apply

Applied AI Health Data Architect-Senior Manager

PwC • Irvine, CA • 7h ago

Hospital & Medical

7h ago

Go to Apply

Applied AI Health Data Architect-Senior Manager

PwC • Los Angeles, CA • 7h ago

Hospital & Medical

7h ago

Go to Apply

Electrical Technician Metrologist

MICRO PRECISION, LLC • Orange, CA • 9h ago

Hospital & Medical

Description Responsible for calibrating a variety of test instruments for one or more skill areas, such as: Electrical Equipment Industrial Equipment Temperature Equipment Perform standards maintenance & checking of...

9h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.