The Behavioral Health Medical Director- Child Psychiatrist is responsible for completing medical necessity reviews for general child psychiatry cases as well as Applied Behavioral Analysis cases supporting commercial and Medicaid business lines. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. Schedule is full-time, Monday through Friday, with openness to part-time. Responsibilities include conducting peer-to-peer clinical reviews with attending physicians or other providers, applying clinical knowledge and skills to utilization review processes, adhering to medical policies and clinical guidelines, engaging in clinical and non-clinical activities impacting healthcare quality, cost, and outcomes, providing guidance for clinical operational aspects of programs, serving on internal and/or external committees, developing and proposing new medical policies, and identifying opportunities for innovation to increase effectiveness and quality. Minimum requirements include MD or DO with Board certification approved by ABMS or AOA, active unrestricted medical license to practice in California, minimum 10 years clinical experience, and for Health Solutions and Carelon organizations, minimum 5 years healthcare experience. Preferred qualifications include willingness to obtain California medical license and Board Certification in Child & Adolescent psychiatry. The position is director level and operates primarily in the first shift in the US.
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