Medical Director of Children's Behavioral Health - Full Time

Penfield, NY 14526

Posted: 04/09/2019 Industry: Healthcare Professionals

Our healthcare corporation is recruiting for a Medical Director of Children's Behavioral Health.  This position provides clinical leadership and support for the development and implementation of the Children’s Behavioral Health (BH) Carve-In program and  has overall accountability for Behavioral Health services for all Medicaid Managed Care enrollees under age 21 years.  Successful candidates will posses hold a NYS medical license as a physician board certified in child and adolescent psychiatry without restrictions and free of sanctions from Medicaid or Medicare, a minimum of five years of experience working with children in BH managed care settings or BH clinical settings (at least two years must be in a clinical setting), a minimum of ten years medical experience and a strong working knowledge of QM/UM.

Responsibilities

• Leads interdisciplinary complex care management rounds. 

• Provision of clinical oversight and leadership to Utilization Management/Case Management (UM/CM) staff working with the children’s population. 

• Develops, implements, and interprets clinical-medical policies and procedures (P&Ps) that are specific to the benefits and services of this transition or can be expected to impact the overall health, recovery and wellbeing of children.

• Oversight on the Administration of BH QM/UM and performance improvement activities, including grievances and appeals

.• Develops and implements performance and quality improvement initiatives that improve clinical outcomes and operational effectiveness. 

• Interprets existing policies and develops new policies, as needed. 

• Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are in compliance with these requirements.

Minimum Qualifications 
• Must hold a NYS medical license as a physician board certified in child and adolescent psychiatry without restrictions and free of sanctions from Medicaid or Medicare required 
• Minimum of five years of experience working with children in BH managed care settings or BH clinical settings (at least two years must be in a clinical setting). 
• A minimum of ten years medical experience and strong working knowledge of QM/UM. 

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1.800.655.8803 585.295.8553 1777 Penfield Road Penfield, NY 14526