Virginia Premier Health Plan, Inc.

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Associate Medical Director, Behavioral Health

Associate Medical Director, Behavioral Health

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4293

Job Description

Overview

The Associate Behavioral Health Medical Director is responsible for first level behavioral health physician support for medical management clinical functions, including Utilization Management, Case Management, Clinical Quality, Credentialing and Pharmacy. These functions support the overall corporate goals of providing integrated health plan clinical operations and ensuring effective delivery of high quality behavioral health care. The Associate Behavioral Health Medical Director serves as the designee for the Behavioral Health Medical Director for Virginia Premier committees, including the Health Quality Utilization Management (HQUM) Committee.

Responsibilities

  • Assisting the Behavioral Health Medical Director and the Medical Directors in the following activities:
    • Behavioral Health Utilization Management
    • Behavioral Health Quality Assessment and Improvement activities
    • Outreach programs
    • Develop clinical practice and preventive guidelines
    • Ensure regulatory and accreditation compliance
    • Serve as a Virginia Premier representative in designated local meetings with managers, provider offices, local and state health care organizations
    • Review pharmacy initial and subsequent requests to determine medical necessity.
    • Monitor provider performance
    • Recommend departmental improvements
  • Resource for Medical Management staff for care coordination and management for ambulatory and inpatient services
  • Serve as the primary medical review physician for behavioral health
  • Demonstrate collaboration with Virginia Premier staff and management to achieve goals and objectives of the department and organization

Qualifications

MINIMUM EDUCATION REQUIREMENTS

  • Maintain a Current Unrestricted Virginia Physician License
  • Board Certification in Psychiatry required  

 

SPECIAL KNOWLEDGE AND/OR SKILLS

  • Commitment to clinical programs and mission to serve the Medicaid population
  • Ability to work with colleagues and other health care professionals to resolve utilization and quality management issues
  • Ability to communicate effectively with health professionals, administrators and staff, both orally and in writing
  • Ability to review the medical literature to answer a clinical question
  • Basic computer skills

WORK BACKGROUND/EXPERIENCE

  • Minimum of five years clinical experience
  • Experience in managed care medical management preferred

 

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position

 

About Us

Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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