Behavioral Health Medical Director (must reside in OH) - AmeriHealth Caritas
Columbus, OH
About the Job
Behavioral Health Medical Director (must reside in OH)
Location: Columbus, OH
Primary Job Function: Behavioral Health
ID: 34228
Job Brief
Qualified candidates must reside in Ohio.
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
The Behavioral Health Medical Director provides clinical oversight and direction to the Clinical Department. He/she is the designated behavioral health care practitioner with oversight of the Quality Improvement (QI) program. The Behavioral Medical Director is an active participant in QI Committee meetings providing clinical consultation, and holds final authority for recommendations for medical necessity and appropriateness or quality of care decisions. The Behavioral Medical Director reviews and approves the Outcomes Management and Quality Improvement Plan. This position is responsible for providing consultation and determinations for clinical cases in need of review. The Behavioral Health Medical Director supports the clinical department in applying Medical Necessity Criteria, to render determinations to requests for specific intensity of service. In addition, the Behavioral Health Medical Director will assess clinical aspects of specific cases and provide feedback to Care Managers pertaining to best practice standards and quality of care issues. This position assists in the development of Medical Necessity Criteria and performs utilization management activities. Assures that organizational medical policies and procedures adhere to contractual obligations.
Education/ Experience:
+ While this is a remote role, qualified candidates must reside in Ohio.
+ Master’s Degree required from an accredited educational program in Social Work, Clinical Counseling, Psychology, Nursing or Behavioral Clinical Specialty.
+ MD Ph.D; Psy.D
+ Board Certified Psychiatrist or Board Certified Psychologist in Ohio
+ 3+ years of behavioral health experience
+ 10+ years post-graduate clinical experience
+ Public sector program management experience desired
+ Experience in crisis intervention, utilization management and benefit plans. S
+ Strong time management, project management, analytical, and organization skills.
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package**
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
EOE Minorities/Females/Protected Veterans/Disabled
Location: Columbus, OH
Primary Job Function: Behavioral Health
ID: 34228
Job Brief
Qualified candidates must reside in Ohio.
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
The Behavioral Health Medical Director provides clinical oversight and direction to the Clinical Department. He/she is the designated behavioral health care practitioner with oversight of the Quality Improvement (QI) program. The Behavioral Medical Director is an active participant in QI Committee meetings providing clinical consultation, and holds final authority for recommendations for medical necessity and appropriateness or quality of care decisions. The Behavioral Medical Director reviews and approves the Outcomes Management and Quality Improvement Plan. This position is responsible for providing consultation and determinations for clinical cases in need of review. The Behavioral Health Medical Director supports the clinical department in applying Medical Necessity Criteria, to render determinations to requests for specific intensity of service. In addition, the Behavioral Health Medical Director will assess clinical aspects of specific cases and provide feedback to Care Managers pertaining to best practice standards and quality of care issues. This position assists in the development of Medical Necessity Criteria and performs utilization management activities. Assures that organizational medical policies and procedures adhere to contractual obligations.
Education/ Experience:
+ While this is a remote role, qualified candidates must reside in Ohio.
+ Master’s Degree required from an accredited educational program in Social Work, Clinical Counseling, Psychology, Nursing or Behavioral Clinical Specialty.
+ MD Ph.D; Psy.D
+ Board Certified Psychiatrist or Board Certified Psychologist in Ohio
+ 3+ years of behavioral health experience
+ 10+ years post-graduate clinical experience
+ Public sector program management experience desired
+ Experience in crisis intervention, utilization management and benefit plans. S
+ Strong time management, project management, analytical, and organization skills.
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package**
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
EOE Minorities/Females/Protected Veterans/Disabled
Source : AmeriHealth Caritas