Medical Director - BH/MH

Job description

Become a part of our caring community The Behavioral Health Medical Director is responsible for behavioral health care strategies and/or operations. You will work assignments involving moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Responsibilities: - Use your medical background, experience, and judgement to make determinations whether requested services, requested level of care, or requested site of service should be authorized, with all work occurring within a context of regulatory compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources - Learn Medicaid requirements and understand how to operationalize this knowledge in your daily work assigned cluster - Work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management, with clinical sc...