Behavioral Health Medical Director
4 weeks ago
JOB SPECIFICATIONS AND CORE COMPETENCIES
- Responsible for making clinical coverage determinations in accordance with the terms of members benefit plans, clinical policies, and objective and evidence - based on written clinical guideline. Adhere to all applicable turnaround time requirements in making coverage and medical necessity determinations, appeal / dispute review decisions, and complaint review decisions, and in notifying members and/or the practitioners in writing, and verbally when required.
- Provide clinical guidance and consultation to the clinical staff at all levels of care in the benefit plan. Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience. Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management.
- Focus on delivery of cost-effective quality care that incorporates recovery, resiliency and person-centered services for all lines of business. Responsible for Level of Care guidelines and utilization management protocols. Collaborates and coordinates with the BH Sr. Manager and BH Director regarding service coordination and care coordination activities.
- Actively contributes to achievement of departmental goals, as identified in Departments annual business plan, including, specific departmental process improvement plans.
QUALIFICATIONS:
- Education/Specialized Training/Licensure: MD/DO, holds a valid Texas license to practice medicine and be registered as a physician in the State of Texas. Board Certified or eligible Psychiatrist for initial employment. Board certification is required. Must meet credentialing criteria.
- Work Experience (Years and Area): Three (3) years' experience as a practicing psychiatrist post residency; Adult Psychiatrist preferred; Child and Adolescent Psychiatry accepted. Experience working with community-based programs and resources designed to aid the State Medicaid and Medicare population required. Knowledge of post- acute care planning such as home care, discharge planning, and disease management.
- Management Experience (Years and Area): 2 years of management experience
- Software Proficiencies: Microsoft Office (Word, Excel, Outlook, PowerPoint)
- Other: Advanced education and training; Adult Psychiatrist preferred; Child and Adolescent Psychiatry Accepted
-
Director of Operations
3 weeks ago
Houston, United States Insynch Health PLLC Full timeJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care. We're looking for a Director of...
-
Director of Operations
4 weeks ago
Houston, United States Insynch Health PLLC Full timeJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care. We're looking for a Director of...
-
Director of Operations
4 weeks ago
Houston, United States Insynch Health PLLC Full timeJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care. We're looking for a Director of...
-
Director of Operations
2 weeks ago
Houston, United States Insynch Health PLLC Full timeJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care. We're looking for a Director of...
-
Director of Operations
3 weeks ago
Houston, United States Insynch Health PLLC Full timeJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care. We're looking for a Director of...
-
Director of Operations
1 week ago
Houston, United States Insynch Health PLLC Full timeJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care. We're looking for a Director of...
-
Director of Operations
1 week ago
Houston, United States Insynch Health PLLC Full timeJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care. We're looking for a Director of...
-
Director of Operations
4 weeks ago
Houston, United States Insynch Health PLLC Full timeJob DescriptionJob DescriptionJoin our rapidly growing Behavioral Health Practice as Director of Practice Operations in Texas. InSynch Health is physician led Behavioral Health company, dedicated to improve health care efficiency and improving lives of our patients. At InSynch Health, we are committed to our patients by delivering best quality care....
-
Behavioral Medical Director
2 weeks ago
Houston, United States Optum Full timeFor those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start **Caring. Connecting. Growing together.** The **Behavioral Medical Director** position is responsible for providing oversight to and direction of the Utilization...
-
Behavioral Medical Director
3 weeks ago
Houston, United States UnitedHealth Group Inc. Full timeFor those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management...
-
Behavioral Medical Director
1 week ago
Houston, United States UnitedHealth Group Inc. Full timeFor those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management...
-
Behavioral Health Medical Director
4 weeks ago
Houston, United States Community Health Choice Full timeJOB SPECIFICATIONS AND CORE COMPETENCIESResponsible for making clinical coverage determinations in accordance with the terms of members benefit plans, clinical policies, and objective and evidence - based on written clinical guideline. Adhere to all applicable turnaround time requirements in making coverage and medical necessity determinations, appeal /...
-
Behavioral Health Medical Director
1 week ago
Houston, United States Community Health Choice Full timeJOB SPECIFICATIONS AND CORE COMPETENCIESResponsible for making clinical coverage determinations in accordance with the terms of members benefit plans, clinical policies, and objective and evidence - based on written clinical guideline. Adhere to all applicable turnaround time requirements in making coverage and medical necessity determinations, appeal /...
-
Behavioral Health Medical Director
4 weeks ago
Houston, United States Community Health Choice Full timeJOB SPECIFICATIONS AND CORE COMPETENCIESResponsible for making clinical coverage determinations in accordance with the terms of members benefit plans, clinical policies, and objective and evidence - based on written clinical guideline. Adhere to all applicable turnaround time requirements in making coverage and medical necessity determinations, appeal /...
-
Behavioral Medical Director
7 days ago
Houston, United States UnitedHealth Group Full timeFor those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management...
-
Behavioral Health Technician
2 weeks ago
Houston, United States Promises Behavioral Health, LLC Full timeJob DescriptionJob DescriptionPosition SummaryThe Behavioral Health Technician (BHT) provides oversight and support services to clients and staff in a residential treatment facility for adults with co-occurring diagnoses. BHT are responsible for around-the-clock supervision of the client milieu and helping to create and maintain a therapeutic milieu for...
-
Behavioral Health Technician
2 weeks ago
Houston, United States Promises Behavioral Health, LLC Full timeJob DescriptionJob DescriptionPosition SummaryThe Behavioral Health Technician (BHT) provides oversight and support services to clients and staff in a residential treatment facility for adults with co-occurring diagnoses. BHT are responsible for around-the-clock supervision of the client milieu and helping to create and maintain a therapeutic milieu for...
-
Director of Residential Services
1 week ago
Houston, United States Promises Behavioral Health, LLC Full timeJob Description Job Description Position Summary The Director of Residential Services (DRS) provides supervision of around-the-clock Behavioral Health staff performing daily client activities in a large residential treatment facility, or for multiple smaller facilities. The DRS is responsible for oversight, monitoring, and tracking of services for clients...
-
Director of Residential Services
3 weeks ago
Houston, United States Promises Behavioral Health, LLC Full timeJob DescriptionJob DescriptionPosition SummaryThe Director of Residential Services (DRS) provides supervision of around-the-clock Behavioral Health staff performing daily client activities in a large residential treatment facility, or for multiple smaller facilities. The DRS is responsible for oversight, monitoring, and tracking of services for clients and...
-
Director of Residential Services
2 months ago
Houston, United States Promises Behavioral Health, LLC Full timeJob DescriptionJob DescriptionPosition SummaryThe Director of Residential Services (DRS) provides supervision of around-the-clock Behavioral Health staff performing daily client activities in a large residential treatment facility, or for multiple smaller facilities. The DRS is responsible for oversight, monitoring, and tracking of services for clients and...
