Senior Medical Director, Behavioral Health Specialist

4 days ago

Albuquerque, New Mexico, United States Magellan Health Full time
Job Summary

We are seeking a highly skilled Senior Medical Director, Behavioral Health to join our team at Magellan Health. This is a full-time position based in Albuquerque, NM.

Key Responsibilities
  • Provide clinical leadership to the interdisciplinary Medical Management team, including clinical/medical oversight of clinical team members and consultation and training with care managers.
  • Develop and implement the Medical Action Plan (MAP) to address the cost of care for all health plans overseen by the assigned position.
  • Monitor and oversee the work of the Medical Directors and Physician Advisors in providing cost-effective and quality care management services.
  • Lead parity efforts and maintain parity documentation and updates with updates in clinical and medical management.
  • Ensure the medical policies, clinical guidelines, quality and clinical operations policies of the company are consistently implemented and NCQA and/or URAC compliant.
  • Develop and provides leadership for NCQA compliant clinical quality improvement activity (QIA) in collaboration with key stakeholders.
  • Recruits, trains, supervises, mentors, oversees and evaluates the quality of medical staff and physician advisors.
  • Develops and manages medical director and physician advisor budgets, travel budgets, and continuing medical education budgets.
Requirements
  • Doctor of Medicine (MD) degree OR Doctor of Osteopathic Medicine (DO) degree OR Bachelor of Medicine, Bachelor of Surgery (MBBS) international degree with successful completion of United States based internship and residency (and successful completion of United States based fellowship for subspecialists) required.
  • Graduate of an American or Canadian medical school accredited by the Accreditation Council for Medical Education (ACME) or equivalent training in a foreign medical school with successful completion of the ECFMG and FLEX examinations.
  • Full training in a residency program in the United States or Canada that is approved by the Accreditation Council for Graduate Medical Education (ACGME).
  • Post-residency experience of at least 7 years involving substantial direct patient care during this period at multiple levels of care.
  • Clinical experience pertinent to the patient population(s) being managed.
  • Unrestricted current and valid license or certification to practice medicine in a state or territory of the United States.
Preferred Qualifications
  • Experience with cost-benefit analysis, medical decision analysis, credentialing, quality assurance and continuous quality improvement (CQI) processes.
  • General knowledge of healthcare industry trends and developments.
What We Offer

Magellan Health offers a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off. We are an equal opportunity employer and welcome applications from diverse candidates.

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