Behavioral Health Medical Director
$236,500–$449,300 year
RemoteTexas, United States
Job Summary
Direct and coordinate medical management, quality improvement, and credentialing functions for the behavioral health business unit. Perform medical reviews for utilization management, quality assurance, and complex case appeals to ensure timely decision-making. Lead performance improvement initiatives, develop physician education policies, and manage physician committees to optimize care quality and cost-effectiveness. Conduct regular rounds for high-risk patients and collaborate with clinical teams on provider network development and market expansion. Identify adverse utilization trends and evaluate provider practice patterns to reduce unwarranted variation in clinical care. Represent the business unit before state committees and the public on medical philosophy and policy issues.
Required Qualifications
- Medical Doctor or Doctor of Osteopathy
- Actively practices medicine
- Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association's Department of Certifying Board Services
- Certification in Psychiatry specialty
- Current Texas state license as a MD or DO without restrictions, limitations, or sanctions from government programs
- Current state medical license without restrictions
- For Behavioral Health only - Board certification by the American Board of Psychiatry and Neurology
- May be required to work weekends and holidays in support of business operations, as needed
Desired Qualifications
- Utilization Management experience and knowledge of quality accreditation standards preferred
- Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is advantageous
- Experience treating or managing care for a culturally diverse population preferred
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