JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care.
Based in Nevada
Essential Job Duties
• Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs.
• Facilitates behavioral health-related regional medical necessity reviews and cross coverage.
• Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses.
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