Medical Director, Behavioral Health – Medicaid
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Job Description
Behavioral Health Medical Director managing strategies and operations for Medicaid services at Humana. Ensuring compliance and collaboration across teams and stakeholders.
Responsibilities:
- Responsible for behavioral health care strategies and/or operations
- Make determinations regarding requested services and levels of care
- Learn and operationalize Medicaid requirements in daily work
- Conduct computer-based review of clinical scenarios and records
- Communicate decisions to internal associates
- Discuss determinations with external physicians and stakeholders
- Support Humana values and collaborate on team activities
- May require coverage for vacations, weekends, and holidays
Requirements:
- Doctor of Medicine or Doctor of Osteopathy
- Board-certified in an ABMS recognized specialty of Psychiatry
- A current and unrestricted license in at least one jurisdiction
- Willing to obtain additional license, if required
- At least five years of experience post-training providing clinical services
- Experience in utilization management review and case management in a health plan setting
- No current sanction from Federal or State Governmental organizations
- Able to pass credentialing requirements
Benefits:
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Paid time off, company and personal holidays
- Volunteer time off
- Paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
- Many other opportunities
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