Behavioral Health Medical Director
Listed on 2026-01-01
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Doctor/Physician
Healthcare Consultant, Medical Doctor
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Position OverviewThe Behavioral Health Medical Director at The Health Plan (THP) provides clinical guidance to Behavioral Health Care Coordination and Utilization Management teams. Key responsibilities include facilitating integrated BH rounds, making clinical coverage determinations, maintaining clinical integrity, and ensuring compliance with evidence-based guidelines. The role involves collaboration with clinical professionals and leadership, focusing on recovery-oriented and cost-effective care. This will be a Dyad relationship with the Directors and VPs of the Clinical Services Department.
Required Qualifications- MD/DO with board certification in Psychiatry, with qualifications in Addiction Psychiatry or Medicine.
- West Virginia and Ohio Physician Licenses or willingness to obtain within 90 days.
- Minimum of three years of clinical experience beyond residency/fellowship; supervisory and teaching experience preferred.
- ASAM Certification.
- Basic computer literacy.
- Prior leadership roles in clinical practice.
- Ability to work harmoniously with professionals and non-professionals.
- Provide physician oversight for Behavioral Health Utilization, Care, Disease, and Quality Management programs, ensuring compliance with NCQA, Medicare, Medicaid, and other regulations.
- Develop and implement clinical practice guidelines and criteria.
- Educate physicians on utilization and quality management protocols.
- Lead and participate in utilization management and quality management committees.
- Review clinical utilization and care delivery, including case reviews and authorization decisions.
- Participate in continuous quality improvement initiatives.
- Collaborate on provider education and intervention programs.
- Perform other duties and special projects as assigned.
Working hours are 8:00am - 5:00pm. The position is at the Director level, full-time, within the Healthcare Provider industry.
This is an equal opportunity employer committed to diversity and inclusion in the workplace.
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