Remote Behavioral Medical Director - Central Region

Overview

This role involves leading medical management and quality improvement initiatives for a national organization, focusing on enhancing care and service quality for members.

In Short

• Direct and coordinate medical management and quality improvement functions.
• Provide medical leadership for utilization management and cost containment.
• Perform medical review activities for complex medical services.
• Support performance improvement initiatives for providers.
• Assist in planning and establishing goals for quality improvement.
• Collaborate with clinical teams and providers on complex cases.
• Participate in provider network development and market expansion.
• Conduct rounds to assess care for high-risk patients.
• Review claims for medical necessity and appropriate payment.
• Represent the business unit at state committees and public forums.

Requirements

• Medical Doctor or Doctor of Osteopathy degree.
• Experience in Utilization Management and quality accreditation.
• Active medical practice.
• Course work in Health Administration or related fields.
• Experience with culturally diverse populations preferred.
• Board certification by the American Board of Psychiatry and Neurology.
• Current state medical license without restrictions.

Benefits

• Competitive pay and health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible work schedules including remote options.
• Comprehensive benefits package.