Behavioral Health Medical Director

Join to apply for the Behavioral Health Medical Director role at Louisiana Healthcare Connections
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We’re a leading healthcare provider, Centene Corporation, offering diverse opportunities for clinical professionals. We invite you to join our Medical Management/Health Services team and impact the care of 28 million members. We are hiring full-time Behavioral Health Medical Director.

• Must be licensed in Louisiana.
• Board certification by the American Board of Psychiatry and Neurology.
• 5+ years of post‑residency experience.

Assist the Sr Medical Director to direct and coordinate medical management, quality improvement, and credentialing functions for the business unit.

• Provide medical leadership for utilization management, cost containment, and quality improvement activities.
• Perform medical review activities for utilization review, quality assurance, and complex medical services, ensuring timely decisions.
• Support implementation of performance improvement initiatives for capitated providers.
• Assist in planning and establishing goals to improve quality and cost‑effectiveness for members.
• Provide expertise in quality improvement and utilization management programs per regulatory and accreditation requirements.
• Assist in the functioning of physician committees, including structure, processes, and membership.
• Conduct rounds to assess high‑risk patients and coordinate care with management teams.
• Collaborate with clinical teams, providers, appeals teams, and consultants on complex cases and medical necessity appeals.
• Participate in provider network development and market expansion.
• Assist in developing and implementing physician education on clinical policies.
• Identify utilization reviews and evaluate trends in utilization, practice patterns, and benefit/payment adequacy.
• Identify quality improvement studies to reduce unwarranted variation and improve cost and quality of care.
• Interface with physicians and providers to implement recommendations improving utilization and quality.
• Review claims for complex or new services to determine medical necessity and payment.
• Develop alliances with the provider community through medical management programs.
• Represent the business unit on public and committee engagements.
• Work weekends and holidays as needed.
• Perform other duties as assigned.
• Comply with all policies and standards.

• Medical Doctor or Doctor of Osteopathy.
• Experience in utilization management and knowledge of quality accreditation standards (preferred).
• Active practice of medicine.
• Coursework in Health Administration, Health Financing, Insurance, or Personnel Management (advantageous).
• Experience caring for a culturally diverse population (preferred).

• Board certification by the American Board of Psychiatry and Neurology.
• Current Louisiana state license as an MD or DO without restrictions or sanctions.

Pay Range: $ - $ per year.

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, holidays, and a flexible work arrangement (remote, hybrid, office).

Centene is an equal‑opportunity employer that values diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.