Humana
Chief Psychiatrist - Behavioral Health Medical Director
Humana, Indiana, Pennsylvania, us, 15705
Chief Psychiatrist - Behavioral Health Medical Director
Join to apply for the Chief Psychiatrist - Behavioral Health Medical Director role at Humana. Base pay range
$223,800.00/yr - $313,100.00/yr Position Responsibilities
Leads clinical and quality management components of Humana’s BH services Oversees, monitors, and assists with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of prior authorization, clinical appropriateness of use; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health–related concerns not requiring referral to behavioral health specialists Develops comprehensive care programs for the management of adult behavioral health concerns typically treated by PCPs, such as ADHD and depression Develops targeted education and training for contracted PCPs to screen for mental health and substance use disorders (SUD) using evidence–based tools (e.g., AUDIT–C, PHQ–9 and GAD–7), performs diagnostic assessments, provides counseling and prescribe pharmacotherapy when indicated, and builds collaborative care models in their practices Coordinates with the Medical Director to integrate the administration and management of behavioral and physical health services Oversees, monitors, and assists with effective implementation of the Quality Management (QM) program; and works closely with the Utilization Management (UM) of services and associated appeals related to adults with mental illness and/or SUD Leads BH policy development in Illinois, driving implementation, oversight, and accountability for both Humana internal and external stakeholders including but not limited to the Department Healthcare and Family Services (HFS), Department of Human Services (DHS), and the Department of Public Health (IDPH) Adheres to and complies with federal and state laws and programmatic requirements Collaborates with Provider relations personnel to ensure high-quality and appropriate care delivered through the BH Provider network Establishes and maintains relationships with Providers, advocates, and other key Illinois stakeholders by maintaining open and ongoing communications; represents Humana at public forums and engagement opportunities Maintains compliance with BH–related Contract requirements and attends oversight committee meetings to ensure appropriate procedures are adhered to within Humana and within care delivery Collaborates closely with corporate and local population health teams in developing programs and strategies to address BH needs at a population health level Required Qualifications
Physician with a current or ability to obtain a unencumbered Illinois‑license and be board‑certified in psychiatry 8+ years clinical experience working in behavioral health Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, UM, discharge planning and/or home health or rehab Must reside in Illinois, or a boarding state (Indiana, Wisconsin and Iowa) and be willing to report to the market office in IL as needed for trainings/meetings Preferred Qualifications
Familiarity with Illinois‑based BH organizations Medicaid Managed Care clinical or behavioral health leadership experience Reside near the border of Illinois in Indiana, Wisconsin and Iowa Work At Home Requirements
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi‑weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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Join to apply for the Chief Psychiatrist - Behavioral Health Medical Director role at Humana. Base pay range
$223,800.00/yr - $313,100.00/yr Position Responsibilities
Leads clinical and quality management components of Humana’s BH services Oversees, monitors, and assists with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of prior authorization, clinical appropriateness of use; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health–related concerns not requiring referral to behavioral health specialists Develops comprehensive care programs for the management of adult behavioral health concerns typically treated by PCPs, such as ADHD and depression Develops targeted education and training for contracted PCPs to screen for mental health and substance use disorders (SUD) using evidence–based tools (e.g., AUDIT–C, PHQ–9 and GAD–7), performs diagnostic assessments, provides counseling and prescribe pharmacotherapy when indicated, and builds collaborative care models in their practices Coordinates with the Medical Director to integrate the administration and management of behavioral and physical health services Oversees, monitors, and assists with effective implementation of the Quality Management (QM) program; and works closely with the Utilization Management (UM) of services and associated appeals related to adults with mental illness and/or SUD Leads BH policy development in Illinois, driving implementation, oversight, and accountability for both Humana internal and external stakeholders including but not limited to the Department Healthcare and Family Services (HFS), Department of Human Services (DHS), and the Department of Public Health (IDPH) Adheres to and complies with federal and state laws and programmatic requirements Collaborates with Provider relations personnel to ensure high-quality and appropriate care delivered through the BH Provider network Establishes and maintains relationships with Providers, advocates, and other key Illinois stakeholders by maintaining open and ongoing communications; represents Humana at public forums and engagement opportunities Maintains compliance with BH–related Contract requirements and attends oversight committee meetings to ensure appropriate procedures are adhered to within Humana and within care delivery Collaborates closely with corporate and local population health teams in developing programs and strategies to address BH needs at a population health level Required Qualifications
Physician with a current or ability to obtain a unencumbered Illinois‑license and be board‑certified in psychiatry 8+ years clinical experience working in behavioral health Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, UM, discharge planning and/or home health or rehab Must reside in Illinois, or a boarding state (Indiana, Wisconsin and Iowa) and be willing to report to the market office in IL as needed for trainings/meetings Preferred Qualifications
Familiarity with Illinois‑based BH organizations Medicaid Managed Care clinical or behavioral health leadership experience Reside near the border of Illinois in Indiana, Wisconsin and Iowa Work At Home Requirements
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi‑weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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