Behavioral Health Medical Director

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.Acentra is looking for a Part-Time Behavioral Health Medical Director to join our growing team.Job Summary:The Part-Time Behavioral Health Medical Director shall provide the clinical and administrative medical oversight for Behavioral Health Utilization Management reviews. The Medical Director will be responsible for providing leadership to the Behavioral Health physician reviewers. Moreover, the Medical Director will provide clinical determinations on behavioral health service requests utilizing nationally recognized criteria and clinical expertise.Job Responsibilities:Evaluate, redirect, and/or respond to inquiries from physicians, providers, and customers. Consult with general and/or specialty practitioners regularly and as necessary as business needs require.Respond to telephone calls and letters to foster appropriate external relationships with attending physicians/surgeons/behavioral health providers.Analyze and remain current on national, state, and local regulations and legislation that impact the healthcare profession.Review pediatric medical literature, information trends, experiences, and approaches, and assist in the development of strategic plans for clinical improvements.Ensure compliance with regulatory and accreditation requirements.Participate in activities specific to contractual arrangements remotely and in person, if required (i.e., Fair Hearings and Appeals).Provide medical expertise with respect to planning and establishing goals and policies to improve medical management.Conduct peer-to-peer physician consultations as requested or required and document consultations.Work with medical, nursing, and administrative staff to identify matters needing shared attention.Discuss, inform, and facilitate communication and interaction between staff with customers.Provide and review for medical necessity for services (e.g., PRTF, ABA, and Mental Health, including Psychiatry).Required Qualifications/Experience:Psychiatrist (MD/DO) with a current non-restricted license to practice medicine by the Board of Medical Examiners.Preferred Qualifications/Experience:10+ years of clinical practice.2+ years as a Medical Director in a managed care company.Board certification in a clinical specialty if MD or DO.Experience in Utilization Management (UM) with knowledge of Medicaid and Medicare programs.Prior Review experience or Quality Assurance committee responsibility in a hospital setting.Utilization Management (UM) review experience.Experience as a physician executive with significant accomplishments in developing managed care strategies, integrating delivery systems, improving quality and utilization management programs, and coaching medical staff on healthcare business and practice issues.A strong knowledge of Quality Assurance (QA) and Utilization Review (UR).A contemporary clinician who understands major trends in healthcare and managed care.Ability to work effectively with a diversity of personalities. Must be approachable, show respect for others, and build consensus.A systems thinker with strong organizational skills who can pull all the pieces together and deliver on time and within budget.Adaptable with a strong collaborative management style, a creative thinker with high energy and enthusiasm, and a team player who promotes the concepts of people working together.Able to adapt to frequently changing work parameters.

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