Medical Director - Behavioral Health, bolthires Medicaid at Oklahoma Staffing Oklahoma City, OK

Medical Director - Behavioral Health, bolthires Medicaid job at Oklahoma Staffing. Oklahoma City, OK. Medical Director (Behavioral Health) At bolthires, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.And we do it all with heart, each and every day. This is a remote-based (work from home) role. In this role as Medical Director (Behavioral Health), you will:Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical necessity decisionsProvide comprehensive behavioral health care management to facilitate delivery of appropriate quality care and improve program/operational efficiency involving clinical issuesParticipate in the appeals process, including the investigation of adverse events and quality of care concernsProvide psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical oversight, consultation and trainingProvide day-to-day physician oversight including management of high-risk cases throughout treatment/levels of care and medical necessity decisionsAssist with the development, implementation, monitoring and evaluation of the utilization management program and action plan, ensuring quality and appropriateness of careAssist with the development, implementation and interpretation of medical policy including medical necessity criteria, clinical practice guidelines and new technology assessmentsParticipate in the development, implementation, and evaluation of clinical/medical programsConfer with behavioral health practitioners regarding the care of patients with severe, complex and/or treatment resistant illnessesIdentify and address quality of care concerns with providers involved in a member's careProvide psychiatric leadership for NCQA-compliant clinical quality improvement activities in collaboration with clinical and quality improvement staffParticipate in the triage and referral for care managementProvide weekend coverage every 6-7 weeks.Perform other duties as deemed necessary. Required QualificationsBoard Certification in PsychiatryActive and current state medical license without encumbrances, and ability to obtain other state licenses. Preferred QualificationsMinimum 5 years of clinical practice experience in the health care delivery field as a psychiatrist. Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. Child/Adolescent Board CertificationEducationMD or DO.Pay RangeThe typical pay range for this role is: $174,070.00 - $374,920.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a bolthires bonus, commission or short-term incentive program in addition to the base pay range listed above.This position also includes an award bolthires in the company's equity award program. Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.No-bolthires programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. We anticipate the application window for this opening will close on: 08/22/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. Oklahoma Staffing Apply tot his job