Medical Director – Behavioral Health

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🔥 1 minute ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $174.1k - $374.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Provide leadership and day-to-day physician oversight for the utilization management team • Manage high-risk cases and medical necessity decisions • Provide comprehensive behavioral health care management to facilitate appropriate quality care and improve operational efficiency • Participate in the appeals process, including investigation of adverse events and quality of care concerns • Provide psychiatric leadership, medical/clinical oversight, consultation, and training to an interdisciplinary utilization management team • Assist with development, implementation, monitoring, and evaluation of the utilization management program and action plan • Assist with development, implementation, and interpretation of medical policy, medical necessity criteria, clinical practice guidelines, and new technology assessments • Participate in development, implementation, and evaluation of clinical and medical programs • Confer with behavioral health practitioners regarding patients with severe, complex, or treatment-resistant illnesses • Identify and address quality-of-care concerns with providers • Provide psychiatric leadership for NCQA-compliant clinical quality improvement activities • Participate in triage and referral for care management • Provide weekend coverage every 6–7 weeks • Perform other duties as deemed necessary

🎯 Requirements

• Board-certified Psychiatrist currently licensed in the State of Ohio or with the ability to become licensed in the State of Ohio • Active and current state medical license without encumbrances • Ability to obtain other state licenses • Ability to get additional state licensures and provide utilization management coverage across multiple state health plans • Minimum 5 years of clinical practice experience in the health care delivery field as a psychiatrist • Experience with managed care, as a provider and manager of care utilization review or physician advisor experience • MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) • Child/Adolescent Board Certification preferred • Preferred candidate will reside in the state of Ohio

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being

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