New Jersey

The Behavioral Medical Director supports the Clinical Department by providing consultation regarding the clinical aspects of specific cases and offering guidance pertaining to best practice standards and quality of care issues. The primary responsibilities include making utilization determinations, as needed, addressing quality concerns through peer to peer consultations.

The Psychiatrist shall review all denials of care for behavioral health treatment services prior to notifying the Provider and Enrollee in writing. The candidate is responsible for activities and consultation regarding program initiatives, committee representation, and process enhancement and providing internal and external training. These activities involve research and data analysis, special projects, program development, evaluation of new services, writing best practice guidelines, and quality monitoring.

The incumbent will adhere to all policies and procedures including but not limited to: Employee Handbook, Corporate Code of Conduct, Confidentiality and the Corporate Compliance Program, which includes Fraud, Waste and Abuse.

Requirements

  • Behavioral Managed Care experience preferred.
  • Clinical practice experience required.
  • MD
  • Must hold a valid, unrestricted state medical license in the State(s) they are working in.
  • Board Certified in either general psychiatry or child psychiatry.

Apply Now

Not sure if you want to apply?
Contact us for more info:
Rebecka Boyd
804-502-0870
nexusexecutivesearch@gmail.com