Associate Medical Director - Behavioral Health

CareOregon•WFH (Oregon), OR

1d•$243,450 - $297,550•Remote

About The Position

The Associate Medical Director for Behavioral Health is responsible for implementing effective utilization review, care management and other clinical practice improvement initiatives as assigned by the Senior Medical Director and/or the Director of Behavioral Health. This position may be assigned to lead medical management initiatives for the organization including clinical quality in the provider network, as well as utilization, quality, case management and disease management operations, monitoring and results, in the business areas of integration and behavioral health.

Requirements

Doctor of medicine or osteopathy in the specialty area of adult psychiatry, as well as possession of or ability to obtain an unrestricted license to practice in Oregon
Board certification in adult psychiatry

Nice To Haves

Board certification, as well as a minimum of two years of progressively responsible people management experience, preferably to include managed care, quality assurance, and utilization review and case management experience
Minimum of two years of progressive leadership experience in a managed care organization or practice setting, preferably with Medicaid, including or following strong clinical practice activity
Medical policy knowledge and skills as related to quality, case and disease management and credentialing activities
Clinical knowledge of the management of diverse medical problems
Basic knowledge of applicable regulatory and contractual requirements for Medicaid, Medicare, and commercial insurance
Understanding of managed care operations
Familiarity with guideline development, outcomes management, population health improvement, disease management and cost effectiveness and cost analysis studies
Awareness of physician/provider payment issues, physician practice models and total quality and continuous quality improvement concepts
Excellent communication and collaboration skills for work with network providers and internal employees
Ability to create excitement and bring individuals and teams together and meld into a cohesive unit.
Ability to work effectively as part of a cross-functional team and foster an environment where change is embraced and supported
Ability to deal with issues and problems systemically
Proven ability to work as an integral part of a team
Ability to plan, set priorities, delegate effectively and utilize time efficiently
Experience applying innovative and creative approaches to improve health care delivery
Demonstrated use of quality management techniques in a large, organized managed care setting
Demonstrated commitment to improving access and quality of care to the underserved and uninsured
Appreciation of cultural diversity and the needs of serving a diverse patient population
Demonstrated comfort, enjoyment and facility to continuously interact with professional colleagues individually and in groups concerning health management, treatment and health data
Must be a results-oriented decision-maker with the ability to balance diverse priorities
Possess a high degree of initiative and motivation along with the ability to effectively support and collaborate with others to achieve business objectives
Ability to work effectively with diverse individuals and groups
Ability to learn, focus, understand, and evaluate information and determine appropriate actions
Ability to accept direction and feedback, as well as tolerate and manage stress
Ability to see, read, hear, speak clearly and perform repetitive finger and wrist movement for at least 6 hours/day

Responsibilities

With the Senior Medical Director and the Director of Behavioral Health, develop, implement and execute effective programs in all areas of integration and behavioral health.
Work with colleagues to develop, implement and manage clinical and wellness programs to address the needs of members.
Collaboration with diverse multi-disciplinary teams within and outside the organization.
Implement, direct and oversee utilization, case, disease, and/or quality management programs.
Develop and implement programs for educating participating physicians regarding quality management and utilization management issues.
Represent the health plan in applicable activities including medical and other professional organizations. Participate in activities that enhance CareOregon’s image within the community.
Serve as a representative and medical spokesperson for the plan in support of service area expansions, contract negotiations and other provider expansion activities.
Provide the leadership necessary to maintain a motivated, productive and competent team through open communication and delegation of responsibilities and authority.

Benefits

competitive pay
bonus opportunity
medical, dental, vision, life, AD&D, and disability insurance
health savings account
flexible spending account(s)
lifestyle spending account
employee assistance program
wellness program
discounts
multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
strong retirement plan with employer contributions
PTO and Paid State Sick Time
paid holidays
volunteer time
jury duty
bereavement leave