Behavioral Health Medical Director - Judge Group

Location: Wheeling, WV
Salary: $250,000.00 USD Annually - $275,000.00 USD Annually
Description: Our client is currently seeking a Behavioral Health Medical Director
The Behavioral Health Medical Director position involves providing clinical guidance to the 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 requires collaboration with various clinical professionals and leadership teams, focusing on recovery oriented and cost-effective care. This will be a Dyad relationship with the Directors and VP's of the Clinical Services Department

This job will have the following responsibilities:

• 1. Provide Physician oversight for activities related to the company’s Behavioral Health Utilization Management, Care and Disease Management and Quality Management programs ensuring compliance with NCQA, Medicare, Medicaid, and other regulatory entities. Play an active role in preparing for related audits and information requests from such entities. 
• 2. Establish the highest standards of best behavioral health practices for care provided to members through participation in the development of clinical practice guidelines and selection and procurement of suitable proprietary criteria and clinical pathways. 
• 3. Provide physician education regarding The Health Plan BH utilization management and quality management protocols and initiatives. Work with individual physicians or physician groups to achieve acceptance and understanding of The Health Plan medical/BH appropriateness criteria, practice guidelines and patient care programs.
  

Qualifications & Requirements:

• 1. MD/DO with board certification in Psychiatry, with qualifications in Addiction Psychiatry or Medicine. 
• 2. A West Virginia and Ohio Physician License is required. Or willingness to obtain them within 90 days. 
• 3. A minimum of three years of clinical experience beyond residency/fellowship is necessary, with supervisory and teaching experience preferred 4. ASAM Certification is required.
  

Contact: acialone@judge.com