Community Health Choice is looking for a dynamic and innovative clinical leader prepared to make a significant contribution toward advancing mental and behavioral health care in the local community and beyond.
Working collaboratively with the Health Plan’s Medical Director and the clinical, network and quality teams, the Behavioral Health Medical Director is responsible for providing oversight and direction for the Behavioral Health Case Management and Utilization Management/Appeals teams and will facilitate integrated Behavioral Health rounds and interact directly with Psychiatrists, Behavioral Health Providers, and other clinical professionals who consult on various processes and programs. The Behavioral Medical Director is part of a leadership team that manages the development and implementation of evidence-based guidelines and medical expense initiatives and will advise leadership on healthcare system improvement opportunities. The Medical Director will also be responsible for maintaining the clinical integrity of the program, including timely coverage determinations, medical necessity reviews and determinations, appeals, peer-to-peer discussions, and consultations with providers and other community based clinicians, including general practitioners.
· MD/DO, holds a valid Texas license to practice medicine
· Registered physician in the State of Texas
· Board Certified or eligible Psychiatrist upon initial employment
· Must meet credentialing criteria
· Two years' experience in a managed care environment
· Three years' experience as a practicing psychiatrist post residency; Adult Psychiatrist preferred; Child and Adolescent Psychiatry accepted.
· Experience working with community-based programs and resources designed to aid the State Medicaid and Medicare population
· Knowledge of post-acute care planning such as home care, discharge planning, and disease management
In addition to a highly competitive salary with day-1 benefits, Community Health Choice offers:
· Bonus pay, up to 12%
· Relocation assistance
· 401(k) with company match up to 5% and employee catch up contributions up to 75%
· Flexible spending accounts
· Tuition reimbursement
·Continuing education assistance
For immediate consideration, please forward CV or resume to: Martha Jones: Martha.Jones@CommunityHealthChoice.org
About Community Health Choice:
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
· Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
· Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
· Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
· Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.Equal opportunity employer/