Description :
We are currently looking for a half-time Child & Adolescent Psychiatrist Behavioral Health Medical Director to serve as a physician peer reviewer within our Utilization Management program for Maryland Medicaid participants seeking specialty mental health and substance use disorder services.
The successful candidate will work collaboratively with other internal partners such as Care Advocacy, Quality Improvement, and State and Legal Compliance, providing medical subject matter expertise and making coverage decisions based on medical necessity criteria from the Maryland Department of Health and from the American Society of Addiction Medicine.
Other duties include supervision, case review, training and consultations with licensed clinical Care Advocates and other physician Peer Reviewers.
The Behavioral Health Medical Director reports to the Chief Medical Officer.
This is a part-time independent contractor position for 20 hours per week. Work can be performed remotely and / or from our office in Columbia, MD.
Primary Responsibilities include :
- Perform Clinical Case reviews of minors (occasional adults) in conjunction with Clinical and Quality departments
- Consultation with Maryland Medicaid practitioners
- Direct supervision and mentorship to the clinical team
- Participation in clinical work groups as required
- Participation in committees as needed
- Adhere to operational and clinical policies
Required Qualifications :
- Doctor of Medicine or Osteopathy
- Current license to practice as a physician without restrictions in the state of Maryland;
- Board certified by the American Board of Psychiatry and Neurology in Child and Adolescent Psychiatry
- Understanding of the Maryland Public Behavioral Healthcare System, the services available, and the criteria for receiving services, including Applied Behavioral Analysis (ABA)
- Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management
- Computer and typing proficiency, data analysis and strong organizational skills
Preferred Qualifications :
- 5+ years of clinical experience post residency
- 1+ year of managed care experience
- Experience in managing both mental health and substance use disorders
- Experience in public sector delivery systems
- Experience working with community based programs and resources designed to aid the State Medicaid population
- Residing in the state of Maryland
This position is required to complete a contract with the state of MD that ends in December 2024, this specific role will not be renewed past that date.
Psychiatrist Behavioral Health Medical Director-96787
We are currently looking for a half-time Child & Adolescent Psychiatrist Behavioral Health Medical Director to serve as a physician peer reviewer within our Utilization Management program for Maryland Medicaid participants seeking specialty mental health and substance use disorder services. The ...
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