Associate Medical Director - Behavioral Health
Portland, Seattle, Boise, Salt Lake City or remote (within our 4 state footprint)
At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, and Accountability. These values are not just words on paper - we live them every day.
Responsibilities & Requirements
As the Behavioral Health Associate Medical Director, you will appliy medical expertise to help ensure our members receive quality, cost effective clinical care. You will support development and communication of medical policies and clinical programs and work with clinical staff on case management reviews and provide peer-to-peer consultations with providers. May participate on clinical project teams.
- Provides clinical consulting to staff on behavioral health member cases and broader behavioral health trends to ensure members receive quality, cost effective care.
- Conducts high-quality member case reviews and peer-to-peer consultations with providers.
- Communicates with a variety of internal or external stakeholders to promote understanding of care management, utilization management and quality programs.
- Participates on various teams to provide clinical input on medical policy reviews and development and may participate on committees that develop programs impacting clinical interventions, utilization management and case management.
- Stays abreast of industry, medical and technology trends. Identifies and communicates new opportunities that would enhance outcomes and the reputation of the organization.
- Solid understanding of behavioral health continuum of care, treatment protocols, and evidence-basedstandards for both mental health and substance use disorders.
- Demonstrated competency working with hospitals, provider groups, or integrated delivery systems toeffectively manage patient care to improve outcomes.
- Passion for population health and healthcare transformation.
- Strong communication, influencing and facilitation skills with internal staff and external stakeholders, including the ability to resolve issues and seek optimal outcomes.
- General knowledge of the health insurance industry, state and federal regulations, provider reimbursement methods and evolving accountable care and payment models.
- Detail-oriented with orientation to the application of data in managing health and quality outcomes. Ability to effectively utilize systems and technology.
- Demonstrated ability to effectively build relationships, demonstrate empathy and work as part of a team.
Normally to be proficient in the competencies listed above:
- The Associate Medical Director would have a MD or DO degree, at least 3 years clinical experience, or equivalent combination of education and experience.
- Currently licensed as a Psychiatrist in one or more of the 50 states.
- Board-certification by the American Board of Psychiatry & Neurology in General Psychiatry.
- Strong preference for completion of Child & Adolescent Psychiatry Fellowship and/or Addiction Psychiatry Fellowship.
- Qualification by training and experience to render clinical opinions about medical conditions, procedures, and treatments under review.