Medical Director-Health Plan
Job ID #1962623
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About this Role
Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care
Job details
$58.00 / hour
Remote, National
Profession: Medical Director
Facility Type: ???
Specialty: Health Plan
Division:
MedFi
Start Date: 11/03/2025
Responsibilities
• Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified Behavior Analysts for outpatient services and/or psychological testing requests
• Interact with network practitioners to provide education on best practice models and utilization management processes
• Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases
• Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD
• Facilitate outpatient rounds offering clinical input and oversight related to outpatient services
Required Qualifications
• PhD Clinical Psychology
• Licensed Psychologist with a BCBA certification
2+ years of professional exp POST licensure.
• Experience with ABA (Applied behavioral Analysis) with Child/adolescent population experience.
• Experience revewing for other MCO’s would be good, but not required.
o Experience working with children with Autism HIGHLY sought after.