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CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Medical Director – Behavioral Health
Location
Louisiana + 2 moreAll locations: Louisiana | Texas | Vermont
Posted
166 days ago
Salary
$174.1K - $374.9K / year
Seniority
Lead
Job Description
Medical Director – Behavioral Health
CVS Health
• Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical necessity decisions • Participate in the appeals process, including the investigation of adverse events and quality of care concerns • Provide psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical oversight, consultation and training • Assist with the development, implementation, monitoring and evaluation of the utilization management program and action plan, ensuring quality and appropriateness of care • Assist with the development, implementation and interpretation of medical policy including medical necessity criteria, clinical practice guidelines and new technology assessments • Confer with behavioral health practitioners regarding the care of patients with severe, complex and/or treatment resistant illnesses • Identify and address quality of care concerns with providers involved in a member's care • Participate in the triage and referral for care management • Provide weekend coverage every 6-7 weeks.
Job Requirements
- Board Certification in Psychiatry
- Active and current state medical license without encumbrances, and ability to obtain other state licenses.
- Minimum 5 years of clinical practice experience in the health care delivery field as a psychiatrist.
- Experience with managed care, as a provider and manager of care utilization review or physician advisor experience.
- Child/Adolescent Board Certification
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
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