► CareersBehavioral Health Medical Director

Behavioral Health Medical Director

This position is responsible for the oversight of Behavioral Health program, including utilization review. This position has the authority and responsibility to make clinical coverage or denial decisions for Behavioral Health cases, independent of the CMO.


Responsibilities:
  • Responsible for management of Behavioral Health (BH) program oversight.
  • Responsible for daily oversight of BH Medical Management.
  • Participate with CMO in strategic planning around medical services.
  • Has the authority to make clinical coverage and denial decisions for BH cases, independent of the CMO.
  • Member of Clinical Leadership Team.
  • Member of Quality & Utilization Management Committee and Quality Improvement Health Committee.
  • Assist in management and development of Care Management programs, including Case Management, Disease Management and Utilization Management Programs and Policies.
  • Represent Minuteman Health to providers on BH utilization management, quality improvement, P4P program, pharmacy management, etc.

Qualifications:
  • MD/DO degree with Board certification in a medical specialty plus 10 years practice experience.
  • Two years of medical management experience in an insurance plan or multi-specialty group.
  • Master’s Degree in Business Administration or Medical Management highly desirable.
  • Prior management experience.
  • Excellent verbal and written communication skills.
  • Excellent analytical and decision making abilities.
  • Project management skills.

Description of Company:

Minuteman Health is a non-profit health insurance option for Massachusetts and New Hampshire residents. Founded by contributors that include Tufts Medical Center, Vanguard Health Systems and New England Quality Care Alliance (NEQCA), Minuteman offers consumers and employers lower-cost high-quality care with unprecedented transparency, as well as increased efficiency and satisfaction for physicians, patients, and employers alike. Plan members will ultimately govern this health plan via Minuteman’s unique ownership structure.


*Please, NO recruiters or agencies


 


 



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