Chief Psychiatrist - Behavioral Health Medical Director
This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range
$/yr - $/yr
Be part of our caring community — put health first
The Chief Psychiatrist oversees Humana’s behavioral health (BH) clinical program for our Illinois FIDE members. The individual in this role collaborates closely with Clinical Services and the Chief Medical Officer (CMO) to integrate the day-to-day administration and strategic management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and value-based payment programs. The Chief Psychiatrist will be based in Illinois and will also lead the development of new products and services in Humana’s Medicaid BH delivery model.
- Leads clinical and quality management components of Humana’s BH services
- Oversees, monitors, and assists with the management of psychopharmacology PBM activities, including prior authorization, clinical appropriateness of use; consultations and clinical guidance for contracted PCPs treating behavioral health–related concerns not requiring referral to behavioral health specialists
- Develops comprehensive care programs for managing adult behavioral health concerns typically treated by PCPs (e.g., ADHD and depression)
- Develops targeted education and training for contracted PCPs to screen for mental health and substance use disorders using evidence-based tools (e.g., AUDIT-C, PHQ-9, GAD-7); performs diagnostic assessments, provides counseling and prescribes pharmacotherapy when indicated; builds collaborative care models in their practices
- Coordinates with the Medical Director to integrate the administration and management of behavioral and physical health services
- Oversees, monitors, and assists with effective implementation of the Quality Management (QM) program; works with UM on services and related appeals for adults with mental illness and/or SUD
- Leads BH policy development in Illinois, driving implementation, oversight, and accountability for Humana internal and external stakeholders including the Department of Healthcare and Family Services (HFS), Department of Human Services (DHS), and the Department of Public Health (IDPH)
- Adheres to and complies with federal and state laws and programmatic requirements
- Collaborates with Provider relations to ensure high-quality care delivered through the BH Provider network
- Establishes and maintains relationships with Providers, advocates, and other key Illinois stakeholders; represents Humana at public forums and engagement opportunities
- Maintains compliance with BH-related contract requirements and attends oversight committee meetings to ensure appropriate procedures are followed within Humana and care delivery
- Collaborates with corporate and local population health teams to develop programs addressing BH needs at a population health level
Required Qualifications
- Physician with a current or ability to obtain an unencumbered Illinois license and board-certified in psychiatry (Psychiatrist)
- 8+ years of clinical experience in behavioral health
- Analytical and interpretation skills with prior experience leading teams in quality management, UM, discharge planning, and/or home health or rehab
- Must reside in Illinois, or a bordering state (Indiana, Wisconsin, Iowa) and be willing to report to the market office in IL as needed for trainings/meetings
Preferred Qualifications
- Familiarity with Illinois-based BH organizations
- Medicaid Managed Care clinical or behavioral health leadership experience
- Reside near the Illinois border in Indiana, Wisconsin, or Iowa
Work At Home Requirements
- To work effectively, self-provided internet must meet: minimum download speed 25 Mbps and upload speed 10 Mbps; connection can be wireless, wired cable, or DSL
- Satellite, cellular and microwave connections allowed only if approved by leadership
- Employees living and working from home in CA, IL, MT, or SD will be provided bi-weekly internet expense reimbursements
- Humana provides home/office equipment appropriate to meet business requirements
- Work from a dedicated space with…
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