AmeriHealth Caritas Medical Director - Behavioral Health in Raleigh, North Carolina

Medical Director - Behavioral Health

Location: Raleigh, NC

Telecommuter?: No

ID**: 16404

Job Brief

Behavioral Health Psychiatrist

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

This position is contingent upon an award of new business

Responsibilities:

  • Development of clinical practice standards, policies, procedures, and performance;

  • Review and resolution of quality of care problems;

  • Participation in Complaint and Grievance processes related to service denials and clinical practice;

  • Development, implementation, and review of the internal Quality Management and Utilization Management programs;

  • Oversight of the Behavioral Health Managed Care Organization's referral process for specialty and Supplemental Services;

  • Oversight and management of the Behavioral Health Managed Care Organization's behavioral health rehabilitation and residential services for children and adolescents

  • Leadership and direction in the Behavioral Health Managed Care Organization's clinical staff recruitment, credentialing, and privileging activities;

  • Leadership and direction in the Behavioral Health leadership and direction of policies and procedures relating to confidentiality of clinical records; and

  • Participation in any meetings called by the Department.

Education/Experience:

  • Board certified psychiatrist or psychologist licensed in North Carolina

  • At least five (5) years combined experience in a Behavioral Health Clinical setting and two (2) years in a Managed Care Organization

EOE Minorities/Females/Protected Veterans/Disabled