Univera Healthcare

Medical Director, Children's Behavioral Health

Rochester, New York, United States of America · Director

Sponsorship not specified$202k-$303kDetected 64 days ago

RecruitingLeadershipCommunicationMicrosoft Office

About the role

Job Description: Summary: This position assists the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.
Essential Accountabilities: Level I Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members.

Works from a desk most of the time. ************ In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Supports effective implementation of performance improvement initiatives for capitated providers.

Minimum 5 years of experience in a BH managed care settings or BH clinical setting (at least 2 of which are in a clinical setting).
Appropriate training and expertise in general psychiatry and/or addiction disorders.
Level II (in addition to Level I Minimum Qualifications) Superior evidence-based medicine skill set Strong interpersonal skills essential for communication to physicians in the community.

$202,000.00 - $303,000.00 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position.
Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity.
The posted salary range reflects just one component of our total rewards package.
This decision is made on a case-by-case basis.
One I.D.E.A. One you.
Together we can create a better I.D.E.A for our communities.

Level I Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities.
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services.
Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership.
Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
Assists in the development and implementation of physician education with respect to clinical issues and policies.
Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components.

Employer Compensation Range(s): $202,000.00 - $303,000.00 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position.
Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity.
The posted salary range reflects just one component of our total rewards package.
Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

This listing is sourced directly from Univera Healthcare's careers page and normalized into a canonical job model.