CVS Health Behavioral Health Medical Director Jackson, Mississippi Apply Now
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Job Purpose and Summary:
Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna.
Primary Job Duties & Responsibilities:
- Collaborates with health plan Sr Leadership to identify, develop, implement, and evaluate the effectiveness of strategic initiatives.
- Ensures plan makes timely medical decisions, including after-hours consultation as needed.
- Leads all major clinical, population health management, and quality improvement components of the aligned plan.
- Develops, implements and interprets medical policies and procedures.
- Leads the administration of all medical management activities of the aligned Plans.
- Plays a lead role in monitoring the overall safety of members with complex and or comorbid medical conditions.
- Coordinates with the MCOs' care management staff and providers on medical services.
- Serves as a key clinical lead in developing and implementing evidence-based clinical policies and practices.
- Participates in regulatory/accreditation reviews.
- Works with MCO's clinical leadership as needed for integration of all health care needs and services for aligned plan's members.
Position Description:
Aetna Medicare Duals Center of Excellence is searching for a board-certified adult psychiatrist with at least five years’ experience in mental health and substance use disorder services for this work-from-home position.
Required Qualifications:
- Five (5) or more years of experience in Behavioral Health in the healthcare delivery system.
- Three (3) or more years of experience in Managed Care.
- Board Certification in ABMS recognized specialty of Adult Psychiatry.
- Active and current state medical license without encumbrances.
- M.D. or D.O.
- Strong strategic thinking and collaborative skills.
- Ability to analyze data and recognize trends.
- Independently motivated and capable of researching and adjudicating Medicare and Medicaid benefit and coverage decisions.
- Strong communication skills both written and verbal.
CVS Health is an equal opportunity/affirmative action employer. We provide reasonable accommodations to qualified individuals with disabilities.
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