Behavioral Health Medical Dir

MD RequiredPosition Qualifications/RequirementsPhysician with a current unencumbered license through the State Board of Medical ExaminersBoard Certified Psychiatrist with an unrestricted license to practice in Louisiana and any other applicable states, with five years clinical psychiatric experience. Over five years' experience in behavioral health, mental health, and substance abuse managed carePublic-sector program management experienceExperience in crisis intervention, utilization management, and benefit plansMembership in a national professional organization

The primary purpose of the job is to:

The Behavioral Health Medical Director is responsible for guiding development of all Behavioral Health programs and guidelines, and for providing administrative and clinical guidance and expertise to senior management and staff to enhance and improve the quality of care and services provided to ACLA's members. The Behavioral Health Medical Director reports to the Medical Director, Network Management, and must be either located in Louisiana, or available to Louisiana for consultation. The Behavioral Health Medical Director liaison is responsible for providing clinical behavioral health supervision to ACLA. This is a one quarter time position (minimum 10 hours/week).

Principle Accountabilities:

Supports the provision of quality and clinically sound system of care services to all individuals in the system of care.Serves as a medical advisor for clinically related activities in Integrated Care Mgmt.Serves as a liaison to state agencies and partners, community and network Providers.Assures that organization medical policies and procedures adhere to contractual obligations.Establishes prior authorization of clinically appropriate use of psychopharmacology monitors/assists and has oversight for pharmacy benefit manager (PBM) activities. including step therapy requirements for the use of antipsychotics and stimulants for members under age 18;Consults with contracted PCPs treating behavioral health concerns that do not require referral to specialists. Works with medical management staff to create comprehensive care programs for youth and adult concerns, such as depression and ADHD.Performs clinical case reviews in conjunction with Clinical Department.Develops and implements education and training programs for ACLA PCPs focused on commonly-encountered behavioral health issues frequently treated by PCPs.Adheres to all ACFC policies and procedures, including, but not limited to: Corporate Code of Conduct, Confidentiality, and Corporate Compliance.Attends training to ensure a working knowledge of the System of Care internal policies and procedures, including the appeal and reconsideration process.Demonstrates knowledge of prescribed and established medical procedures and practices.Maintains familiarity with federal, state, and local regulations that may pertain to the medical and clinical operations.Adheres to ACFC policies and procedures.Supports and carries out the ACFC Mission & Values.Serves as a consultant to ACLA as indicated.Position Qualifications/RequirementsPhysician with a current unencumbered license through the State Board of Medical ExaminersBoard Certified Psychiatrist with an unrestricted license to practice in Louisiana and any other applicable states, with five years clinical psychiatric experience. Over five years' experience in behavioral health, mental health, and substance abuse managed carePublic-sector program management experienceExperience in crisis intervention, utilization management, and benefit plansMembership in a national professional organizationADA Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Potential Hazards: Some travel.

Minimum Education:

MD

MD

Required

Physician with a current unencumbered license through the State Board of Medical Examiners

Required

Board Certified Psychiatrist with an unrestricted license to practice in Louisiana

Required

Clinical psychiatric experience

Required

5

Years

Experience in behavioral health, mental health, and substance abuse managed care

Required

5

Years

Public-sector program management experience

Required

Experience in crisis intervention, utilization management, and benefit plans

Required

Membership in a national professional organization

Required