Behavioral Health Medical Director

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomesmaking this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra is looking for a Part-Time Behavioral Health Medical Directorto join our growing team.

The Part-Time Behavioral Health Medical Director shall provide the clinical and administrative medical oversight for Behavioral Health Utilization Management reviews. The Medical Director will be responsible for providing leadership to the Behavioral Health physician reviewers. Moreover, the Medical Director will provide clinical determinations on behavioral health service requests utilizing nationally recognized criteria, clinical expertise.

Job Responsibilities:

• Evaluate, redirect, and/or respond to inquiries from physicians, providers, and customers. Consult with general and/or specialty practitioners regularly and as necessary as business needs require.
• Respond to telephone calls and letters to foster appropriate external relationships with attending physicians/ surgeons/behavioral health providers.
• Analyze and remain current on national, state, and local regulations and legislation that impact the healthcare profession.
• Review pediatric medical literature, information trends, experiences, and approaches, and assist in the development of strategic plans for clinical improvements.
• Ensure compliance with regulatory and accreditation requirements.
• Participate in activities specific to contractual arrangements remotely and in person, if required (i.e., Fair Hearings and Appeals).
• Provide medical expertise with respect to planning and establishing goals and policies to improve medical management.
• Conduct peer-to-peer physician consultations as requested or required and document consultations.
• Work with medical, nursing, and administrative staff to identify matters needing shared attention.
• Discuss, inform, and facilitate communication and interaction between staff with customers.
• Provide and review for medical necessity for services (e.g., PRTF, ABA, and Mental Health, including Psychiatry).

Requirements

Required Qualifications/Experience

• Psychiatrist (MD/DO) with a current non-restricted license to practice medicine by the Board of Medical Examiners.

Preferred Qualifications/Experience:

• 10+ years of clinical practice.
• 2+ years as a Medical Director in a managed care company.
• Board certification in a clinical specialty if MD or DO.
• Experience in Utilization Management (UM) with knowledge of Medicaid and Medicare programs.
• Prior Review experience or Quality Assurance committee responsibility in a hospital setting.
• Utilization Management (UM) review experience.
• Experience as a physician executive with significant accomplishments in developing managed care strategies, integrating delivery systems, improving quality and utilization management programs, and coaching medical staff on healthcare business and practice issues.
• A strong knowledge of Quality Assurance (QA) and Utilization Review (UR).
• A contemporary clinician who understands major trends in healthcare and managed care.
• Ability to work effectively with a diversity of personalities. Must be approachable, show respect for others, and build consensus.
• A systems thinker with strong organizational skills who can pull all the pieces together and deliver on time and within budget.
• Adaptable with a strong collaborative management style, a creative thinker with high energy and enthusiasm, and a team player who promotes the concepts of people working together.
• Able to adapt to frequently changing work parameters.

Benefits

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Compensation

The pay range for this position is $93.42/hr-$175.00/hr

"Based on our compensation program, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.