Health Care

applicants

Contribute as a key member in driving this organization to the top position in behavioral managed care. Responsible for organization's clinical vision, philosophy and strategy and effectively represent the organization to various public stakeholders both locally and nationally.Oversee overall medical management and quality improvement programs support of the organization’s strategic plan.  Oversee and support the medical management structure, assuring high quality care and compliance with regulatory and accreditation requirements. Administrative oversight and accountability for the quality improvement department. Recruit, coordinate and oversee activities of assistant medical directors and physician advisors. Recruit and utilize the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participate in provider network development and new market expansion as appropriate. Responsible for business unit physician committees including committee structure, processes and membership.  Review and participate in the clinical response to RFP’s as requested. EXPERIENCE REQUIRED:Requires an unrestricted licensed Medical Doctor or Doctor of Osteopathy, board certification in Psychiatry required. TX license preferred. Previous experience as a senior level medical position with a managed behavioral health organization is required. Prior experience as a Medical Director for an MBHO with Medicaid/Medicare programs is preferred. Experience treating or managing care for a culturally diverse population preferred. Experience with quality improvement for an organization as well as knowledge of certification/accreditation standards such as URAC, NCQA is preferred. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is a plus. ABOUT OUR FIRM:Health Career Professionals, LLC is a health care executive search and talent management firm who provides professional services to health care professionals and companies.  Our clients are national and regional health care plans who seek the services clinical and operational professionals in contract, interim, and permanent positions.By applying to this position you are agreeing to receive additional information from our firm and our periodic email newsletter about new opportunities and career information.  Your personal information is NEVER released to any third parties.