Behavioral Health Medical Director (Remote Indiana, Illinois, Michigan, or Ohio)

Acentra seeks a Behavioral Health Medical Director-Psychiatrist or HSPP with active license (Remote within Indiana, Illinois, Michigan, or Ohio) to join our growing team.

Job Summary:

The Behavioral Health Medical Director shall provide the clinical and administrative medical oversight for Behavioral Health Utilization Management reviews. The Medical Director will be responsible for providing leadership to the Behavioral Health physician reviewers. Moreover, the Medical Director will provide clinical determinations on behavioral health service requests utilizing nationally recognized criteria, clinical expertise.

Job Responsibilities:

• Evaluate, redirect, and/or respond to inquiries from physicians, providers, and customers. Consult with general and/or specialty practitioners regularly and as necessary as business needs require
• Respond to telephone calls and letters to foster appropriate external relationships with attending physicians/ surgeons/behavioral health providers
• Analyze and remain current on national, state, and local regulations and legislation that impact the healthcare profession
• Review pediatric medical literature, information trends, experiences, and approaches, and assist in the development of strategic plans for clinical improvements
• Ensure compliance with regulatory and accreditation requirements
• Participate in activities specific to contractual arrangements remotely and in person, if required (i.e., Fair Hearings and Appeals)
• Provide medical expertise with respect to planning and establishing goals and policies to improve medical management
• Conduct peer-to-peer physician consultations as requested or required and document consultations
• Work with medical, nursing, and administrative staff to identify matters needing shared attention
• Discuss, inform, and facilitate communication and interaction between staff with customers
• Provide and review for medical necessity for services (e.g., PRTF, ABA, and Mental Health, including Psychiatry)

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement you need to achieve the finest work of your career.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

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Requirements

Qualifications:

• Psychiatrist (MD/DO) or Health Services Provider in Psychology (HSPP) (Ph.D.)
• Current, non-restricted license to practice medicine
• Must be willing to relocate to Indiana, Illinois, Michigan, or Ohio

Experience:

• Experience conducting outreach to Indiana providers and completing behavioral health utilization review tasks
• Experience providing outreach to Indiana providers and complete behavioral health utilization review tasks
• Reviewing medical records to determine patient's behavioral treatments (1. Proven track record as a physician executive with significant achievements, 2. Developing managed care strategies, 3. Integrating delivery systems, 4. Improving quality and utilization management programs, 5. Coaching medical staff on healthcare business and practice issues)

Leadership:

• Serve as the Lead Behavioral Health Medical Director for the plan
• Provide input on all aspects of clinical operations
• Develop and direct initiatives to enhance quality