Medical Director, Behavioral Health (PST)
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Before you apply
LocationUnited States
SeniorityDirector
Experience3+ yrs
Company size10,000+ people
First seenOct 30, 2026 · 4d ago
Verified live14h ago
At a glanceSummarised by Seekless from the posting.
At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience
Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice
Board Certification in Psychiatry
Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff
Ability to work cross-collaboratively within a highly matrixed organization
Strong organizational and time-management skills
Ability to multi-task and meet deadlines
Attention to detail
Critical-thinking and active listening skills
Decision-making and problem-solving skills
Strong verbal and written communication skills
Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs
Experience with utilization/quality program management
Managed care experience
Peer review experience
Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification
Skills
Microsoft Office
About the role
JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care.
Responsibilities
Essential Job Duties
• Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs.
• Facilitates behavioral health-related regional medical necessity reviews and cross coverage.
• Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses.
• Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts.
• Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment.
• Provides second level behavioral health clinical reviews, peer reviews and appeals.
• Supports behavioral health committees for quality compliance.
• Implements behavioral health specific clinical practice guidelines and medical necessity review criteria.
• Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS).
• Assists with the recruitment and orientation of new psychiatric medical directors.
• Ensures all behavioral health programs and policies are in line with industry standards and best practices.
• Assists with new program implementation and supports for health plan in-source behavioral health services.
Requirements
Required Qualifications
• At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience.
• Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice.
• Board Certification in Psychiatry.
• Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff.
• Ability to work cross-collaboratively within a highly matrixed organization.
• Strong organizational and time-management skills.
• Ability to multi-task and meet deadlines.
• Attention to detail.
• Critical-thinking and active listening skills.
• Decision-making and problem-solving skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.
Nice to have
Preferred Qualifications
• Experience with utilization/quality program management.
• Managed care experience.
• Peer review experience.
• Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Legal
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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