Chief Psychiatrist - Behavioral Health Medical Director

Become a part of our caring community and help us put health first

The Chief Psychiatrist oversees our 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.

Position Responsibilities:

• Leads clinical and quality management components of Humana’s BH services

• Oversees, monitors, and assists with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of prior authorization, clinical appropriateness of use; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health‑related concerns not requiring referral to behavioral health specialists

• Develops comprehensive care programs for the management of adult behavioral health concerns typically treated by PCPs, such as ADHD and depression

• Develops targeted education and training for contracted PCPs to screen for mental health and substance use disorders (SUD) using evidence‑based tools (e.g., AUDIT‑C, PHQ‑9 and GAD‑7), performs diagnostic assessments, provide counseling and prescribe pharmacotherapy when indicated, and build 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; and work closely with the Utilization Management (UM) of services and associated appeals related to adults with mental illness and/or SUD

• Leads BH policy development in Illinois, driving implementation, oversight, and accountability for both Humana internal and external stakeholders including but not limited to the Department 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 personnel to ensure high‑quality and appropriate care delivered through the BH Provider network

• Establishes and maintains relationships with Providers, advocates, and other key Illinois stakeholders by maintaining open and ongoing communications; 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 adhered to within Humana and within care delivery

• Collaborates closely with corporate and local population health teams in developing programs and strategies to address BH needs at a population health level

Use your skills to make an impact

Required Qualifications

• Physician with a current or ability to obtain, unencumbered Illinois‑license and be board‑certified in psychiatry‑ Psychiatrist

• 8+ years clinical experience working in behavioral health

• Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, UM, discharge planning and/or home health or rehab

• Must reside in Illinois, or a boarding state (Indiana, Wisconsin and 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 border of Illinois in Indiana, Wisconsin and Iowa

Work at Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self‑provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required.

• Satellit…