Job DescriptionBehavioral Health
Medical Director supporting the
TriCare/Department of Defense and
Community Care Network/Department of Veterans Affairs. This remote-based civilian position is an outstanding chance to make a meaningful contribution to the healthcare of veterans and military beneficiaries while benefiting from work-life flexibility, professional collaboration, and impactful leadership.
Join us in leading high-quality care initiatives for those who have served our country, with a focus on system-wide clinical improvement, peer collaboration, and mission-driven support!
Requirements:- Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school.
- Active, unrestricted license to practice medicine in the United States.
- Board certification or board eligibility through a recognized specialty board.
- U.S. Citizenship.
- Favorable background investigation through the Department of Defense (DoD).
- Minimum of 5 years of medical practice experience.
- 3+ years of experience in managed care environments.
Preferred:- Experience working with TRICARE, Veterans Affairs, or other federal health plans.
- Advanced degree in management (MPA, MBA, MHA, MPH).
- Corporate-level leadership experience.
- Experience using InterQual and/or similar evidence-based criterial to assess medical interventions, procedures and treatments.
Job Responsibilities:- Provide program-wide clinical guidance across multiple medical management domains including Utilization Management, Case Management, Quality, and Public Health.
- Lead and participate in quality committees and collaborative safety initiatives.
- Review member cases for appropriateness and quality of care; document findings in CareRadius and other health systems.
- Conduct peer-to-peer discussions with network providers and internal stakeholders.
- Develop and implement corrective action plans related to clinical quality or provider performance.
- Collaborate closely with TriWest teams such as Clinical Operations, Data Analytics, and General Counsel.
- Provide clinical expertise on new technologies, treatment protocols, and population health initiatives.
- Interact with veterans and beneficiaries to support satisfaction and outcomes.
- Stay current with required licensure, board certification, and federal medical standards.
Working Conditions:- Remote position with standard weekday hours and occasional after-hours availability.
- Extensive computer-based work; prolonged periods of sitting may be necessary.
Location : LocationUS-NV-Las Vegas
Recruiter : Full Name: First LastJoseph Day
Direct phone number314-744-4138
Recruiter : Email[email protected] 
