Part Time Medical Director – Behavioral Health

Job not on LinkedIn

October 10

🔔 Pennsylvania – Remote

Although this job is listed in Pennsylvania, this company may be open to hiring remote in other states.

💵 $106k - $172.3k / year

⏱ Part Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

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Capital Blue Cross

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Healthcare Insurance • Finance • B2C

Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.

1001 - 5000 employees

Founded 1938

⚕️ Healthcare Insurance

💸 Finance

👥 B2C

📋 Description

• Provides clinical leadership and oversight across Capital’s behavioral health operations, including Utilization Management (UM), Care Management (CM), and clinical rounds • Conducts and oversees medical necessity reviews, benefit determinations, and appeals • Collaborates with internal teams, external partners, and network providers to drive quality, improve member outcomes, and support organizational performance • Analyzes data to identify trends and informs policy and program development • Participates in accreditation and regulatory compliance, actively participating in committees and quality improvement activities

🎯 Requirements

• MD or DO Degree, as well as appropriate Board Certification • Current unrestricted license in Pennsylvania as an MD or DO • Currently covered by, or eligible to be covered by, medical liability insurance • Current valid Pennsylvania drivers’ license • A minimum of five years of clinical experience, post residency, including both inpatient and outpatient care • A minimum of 8 years of experience in health care with an emphasis on analysis and process optimization • Managed Care Organization and/or health insurance plan experience preferred

🏖️ Benefits

• Medical, Dental & Vision coverage • Retirement Plan • Generous time off including Paid Time Off, Holidays, and Volunteer time off • Incentive Plan • Tuition Reimbursement • Comprehensive benefits packaging