Pennsylvania Licensed Behavioral Health Medical Director

Job Summary

A company is looking for a Behavioral Health Medical Director to focus on adult psychiatric cases related to substance abuse.

Key Responsibilities

• Conduct coverage reviews and render determinations based on member plan benefits and review policies
• Document clinical review findings and ensure compliance with policies and regulatory standards
• Engage with providers through peer-to-peer discussions and support organizational accreditation efforts

Required Qualifications

• 5+ years of clinical experience post-residency, including inpatient and outpatient care
• 3+ years of experience in managed care, utilization review, or quality management
• MD or DO degree with appropriate Board certification
• Current unrestricted licensure in Pennsylvania as an MD or DO
• Current coverage, or eligibility for, medical liability insurance