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Humana logo
Humana

Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to off

Lead Medical Director – BH/MH

Location

Louisiana + 4 moreAll locations: Louisiana | Ohio | Oklahoma | South Carolina | Virginia

Posted

74 days ago

Salary

$270.8K - $378.8K / year

Seniority

Senior

Postgraduate Degree5 yrs expEnglish

Job Description

Lead Medical Director – BH/MH

Humana

• Manages a team of Behavioral Health Medical Directors who primarily conduct Behavioral Health case reviews • Provides medical interpretation and decisions about the appropriateness of services • Participates in required state Behavioral Health administrative activities • Oversees and helps to implement the Behavioral Health IRR process • Conducts discussions with external physicians to gather additional clinical information

Job Requirements

  • Doctor of Medicine (MD) or Doctor of Osteopathy (DO)
  • Board-certified in Psychiatry (ABPN)
  • An active and unrestricted license in at least one jurisdiction and willing to obtain a license, as required, for various states in region of assignment
  • At least five years of experience post-residency/internship providing clinical services
  • 2+ years of management experience
  • Experience in utilization management review and case management in a health plan setting
  • Experience with evidence-based guidelines utilized in assisting with determinations (e.g. MCG)

Benefits

  • medical, dental and vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance and many other opportunities

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Head, Medical Governance Office

Takeda Pharmaceuticals

Takeda Pharmaceuticals is a global biopharmaceutical company engaged primarily in the research, development, manufacture, and marketing of pharmaceutical produc

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