Associate Medical Director – Behavioral Health/Utilization Management

🕒 July 8

🥔 Idaho, Oregon, +2 more states – Remote

🥔 Idaho – Remote 🌲 Oregon – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $204k - $333k / year

⏱ Part Time

🔴 Lead

👨‍⚕️ Medical Director

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Cambia Health Solutions

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Cambia Health Solutions is a nonprofit, mission-driven healthcare company based in Portland, Oregon, that operates consumer-focused health care and health insurance businesses and invests in health innovation. It serves as the parent organization for the Regence family of health plans and runs initiatives and subsidiaries focused on improving care delivery, providing insurance products, and developing digital health tools and services.

📋 Description

• Completes Behavioral Health utilization management reviews, including PA, appeals and post-service. • Develops and Implements Behavioral Health Policies and Programs: Assists in developing high-quality, market-competitive behavioral health medical policies and programs, and provides leadership in developing short and long-range plans, goals, and objectives for integrated utilization management. • Operational Leadership and Oversight: Oversees the development of effective operational policies, procedures, and standards for an integrated behavioral health program, monitors utilization and results, and implements process or system changes as needed. • Subject Matter Expert and Clinical Leadership: Serves as a subject matter expert on behavioral health, provides medical advice, oversight, and leadership for staff, and ensures members receive safe, effective, and cost-efficient services. • Collaboration and Communication: Collaborates with the Executive Medical Director of Behavioral Health, leads/participates in teams for medical policy reviews and development, and discusses review determinations with providers to promote understanding of utilization management and quality improvement policies. • Industry Trends and Opportunities: Stays abreast of industry, medical, and technology trends, identifies and communicates new opportunities to enhance outcomes and the organization's reputation, and collaborates to implement actions to reduce medical cost trend.

🎯 Requirements

• Licensed Physician with an MD or DO degree • Active, unrestricted license to practice medicine in one or more of our 4 states. • Board Certification in general psychiatry or child psychiatry required with preference for being board certified in both. • At least 3 years clinical experience. • Two years health plan medical utilization management and/or case management experience. • Equivalent combination of education and experience. • Must be located in one of our four states.

🏖️ Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. • Annual employer contribution to a health savings account. • Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. • Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). • Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). • Award-winning wellness programs that reward you for participation. • Employee Assistance Fund for those in need. • Commute and parking benefits.