Medical Director, Behavioral Health (Hybrid)
Company: Behavioral Health Tech
Location: Baltimore
Posted on: May 2, 2024
Job Description:
Going Digital: Behavioral Health Tech Job Board Going Digital:
Behavioral Health Tech Job Board Medical Director, Behavioral
Health (Hybrid) Baltimore, MD Senior - Full time Posted 7 days ago
Apply Medical Director, Behavioral Health (Hybrid) Job ID: -18574
Job Function: -Medical Management Location: -Baltimore, MD, United
States Campus: -MD-Baltimore-Canton Crossing Career Band: -BDC
Status: Full-Time Resp & QualificationsPURPOSE:The Behavioral
Health Medical Director oversees all activities of utilization
review, care management and quality to determine the medical
effectiveness related to behavioral health and substance use. The
critical responsibility will be the management of care delivery in
a cost effective and quality assured system that will assist the
organization to achieve its corporate mission of serving the
behavioral health needs of members.ESSENTIAL FUNCTIONS:
- Ensure that the provision of behavioral health care service to
the membership is compliant with the medical policies and
standards. Participate in medical necessity reviews, including
pre-service reviews, concurrent reviews of inpatient and post-acute
care, and appeals.
- The Behavioral Health Medical Director will propose policies
and standards for review and resolution to the committee and
communicate these policies and standards to physicians
participating in the network.
- Oversees all activities of behavioral health utilization
review, care management and quality to determine the medical
effectiveness of proposed treatments and approve care management
plans.
- Collaborates with Network Management in improving access to
care.
- Represents company with provider community, professional
organizations, legislative work groups and governmental
agencies.
- Responsibility for after-hours
function.QUALIFICATIONS:Education: -Medical Degree from an
-accredited medical school, completion of an American residency
program.Experience:
- 5 years minimum of -clinical practice experience in the field
of psychiatry
- 2 years managed care experience with Accreditation
experience.Licenses/Certifications:
- MD - Physician - State Licensure Maryland Physician License
without restrictions -
- ABPN - American Board of Psychiatry and Neurology Upon Hire
Required.Knowledge, Skills, and Abilities (KSAs):
- Knowledge of managed care concepts and behavioral health care
management activities.
- Skilled in coordinating and collaborating with physicians.
- Knowledge of patient rights and laws relative to those rights,
such as HIPAA.
- Demonstrated application and knowledge of best behavioral
health clinical practices.
- Knowledge of principles, practices, evidence-based guidelines
and standardized processes and procedures for evaluating medical
support operations business practices.Salary Range: -$219,840 -
$408,078Salary Range DisclaimerSalary -will -be -based -on
-education, -location, -experience, -certifications, -etc. -In
-addition to -your -salary, CareFirst offers benefits such as -a
comprehensive benefits package, incentive and recognition programs,
and 401k contribution (all benefits are subject to eligibility
requirements).DepartmentDepartment: Medical Directors Equal
Employment OpportunityCareFirst BlueCross BlueShield is an Equal
Opportunity (EEO) employer. It is the policy of the -Company to
provide equal employment opportunities to all -qualified applicants
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, age, protected veteran or
disabled status, or genetic information.Where To ApplyPlease visit
our website to apply: -www.carefirst.com/careers Federal
Disc/Physical DemandNote: The incumbent is required to immediately
disclose any debarment, exclusion, or other event that makes
him/her ineligible to perform work directly or indirectly on
Federal health care programs.PHYSICAL DEMANDS:The associate is
primarily seated while performing the duties of the position.
Occasional walking or standing is required. The hands are regularly
used to write, type, key and handle or feel small controls and
objects. The associate must frequently talk and hear. Weights up to
25 pounds are occasionally lifted.Sponsorship in USMust be eligible
to work in the U.S. without Sponsorship.#LI-NH2 Carefirst CareFirst
is a not-for-profit, non-stock health services company. Size:
1001-5000 employees Year Founded: 1934 - 2023 Pallet Labs Inc. See
privacy policy and terms of service Get started on Pallet Going
Digital: Behavioral Health Tech Job Board is on Pallet - Where
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Keywords: Behavioral Health Tech, Annandale , Medical Director, Behavioral Health (Hybrid), Executive , Baltimore, Virginia
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