Aetna Medical Director - Behavioral Health (Psychiatrist) in Kenner, Louisiana
Req ID: 46476BR
The Behavioral Health (BH) Medical Director is responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent responsive integrated care. The BH Medical Director is a critical medical and business leader and contact for external providers, plan sponsors, and regulatory agencies and participates in the strategic medical management of local markets.
Relocation Assistance Available If Needed.
Aetna Better Health of Louisiana is seeking a Psychiatrist to serve as Medical Director for the Behavioral Health operations in Louisiana. As the BH Medical Director you are responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent responsive medical care. The BH Medical Director is a critical medical and business leader and contact for external providers, plan sponsors, and regulatory agencies and participates in the strategic medical management of local markets. We are seeking a candidate that has experience with the SMI Population (Seriously Mentally Ill) for this critical role.
In this role you will:
Lead the clinical staff in the coordination of quality care on behalf of members utilizing their available benefits
Provide clinical expertise and business direction in support of medical management programs through participation in clinical team activities in the execution of precertification, concurrent review/discharge planning, case management, disease management, quality management, disability management and clinical claim review
Partner with medical management leadership to increase effectiveness of medical management programs and to promote the integration of other Aetna medical programs
Provide clinical guidance in operating effective medical programs to promote member quality of care and in reviewing potential lapses in the quality of care
Oversee triage and referral for behavioral health staff in respective regions/units (Behavioral Health Medical Director)
Act as the lead business and clinical liaison to network providers and facilities to support effective execution of the medical services programs by the clinical teams
Participate in quality management activities at regional and market levels including those necessary to achieve NCQA and URAC accreditation
Proactively use data analysis to identify opportunities for quality improvement, to positively influence the effective delivery of quality care
Mentor employees and supports ongoing training and development of clinical staff and acts in a manner consistent with the Aetna Way
Background / Experience Desired:
2-3 years of experience in Health Care Delivery System e.g., Clinical Practice and Health Care Industry. Managed care Experience a plus.
The highest level of education desired for candidates in this position is a MD or DO.
Licenses and Certifications:
Medical/Board Certified, Psychiatry is required. An active unrestricted medical license in the state of Louisiana is required or the ability to obtain an active unrestricted license in Louisiana is required.
Additional Job Information: .
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
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Job Function: Health Care