Medical Director, Behavioral Health

Job Description:

The Medical Director, Psychiatry and Behavioral Health (MD, PBH) is responsible for providing oversight to behavioral health programming in the market. In partnership with the Market Medical Director and the Manager of Behavioral Health, the Medical Director of Psychiatry collaborates with our health plan partners, and leads the development and refinement of clinical practices, policies and programming related to behavioral health. The role works collaboratively with an interdisciplinary team of clinical and non-clinical leadership to support the market.
The MD, PBH also provides comprehensive behavioral health care, including assessments, diagnosis, treatment recommendations, treatment planning, clinical treatment, medication management, and follow up planning. The MD, PBH provides members with a necessary bridge to ongoing behavioral health services in the community and manages the most behaviorally complex patients in their market.

Responsibilities:

Strategy

• Develops and implements cost of care initiatives based on segmentation and other population health drivers and partner with local care teams to further evaluate and iterate initiatives to support high quality member care, for both consented and pre-consented members

• Partners with Cityblock’s Data and Analytics and Population Health teams to understand and map solutions to address drivers of utilization and translate this information to local care teams for iteration of potential data-driven solutions

• Leads clinical quality improvement initiatives that may span multiple locations and that focus on HEDIS, contracted or other determined behavioral health clinical quality metrics, in partnership with Cityblock’s Quality Improvement team

• Decreases unnecessary hospitalizations, emergency room visits, and unnecessary speciality referrals

Case Review and Education

• Participates in case conferences to bring a psychiatric lens to member care

• Supports care team in developing members’ care plans when behavioral health interventions apply

• Guides clinical team on complex clinical cases. Is available for escalation questions at the point of care.

• Participates in the delivery of educational content around behavioral health, and integration of primary and behavioral health needs, across the entire care team including non-clinical staff

Clinical Care

• Conducts psychiatric evaluations for members referred to BH or identified through segmentation and develop comprehensive biopsychosocial formulations and treatment plans

• Conducts visits for medication bridging for any member, and provide medication management for high- or risking-risk members

• Prescribes, as clinically indicated, psychiatric medications, including Medication Assisted Treatment, Long-Acting Injectable medications, Clozapine and certain controlled substances

• Completes comprehensive, compliant diagnosis capture

• Addresses contracted and company prioritized quality gaps and ensure proper chart documentation and codes (ICD or CPT) are included in the encounter as supporting evidence of gap closure

Follow-Up

• Works with members until they are stabilized in the community

• Supports care team providers prescribing psychiatric medications and/or Medication Assisted Treatment

• Collaborates with the care team to determine need for member placement in a different program (e.g., lower or higher intensity programs)

• Facilitates behavioral health and SUD referrals with internal and external providers and develop strong relationships with community and external providers

• Supports members in achieving their behavioral health care plan goals

Partner and Network Management

• Attends external meetings and activities to further the business goals of the organization

Operations

• Works a full-time week and be prepared to join the Cityblock on-call schedule as needed. May need to work outside of regular business hours to execute on the market’s clinical or business needs.

• Utilizes our care facilitation, electronic health record and scheduling platforms as needed to collect data, document member interactions, organizes information, tracks tasks, and communicates with team, members, and community resources

• Cross cover other Cityblock markets in your division

Work Experience:

• At least 2 years post residency with some clinical leadership experience preferred

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role