Behavioral Health Medical Director - Louisiana

Louisiana

full-time
Non clinical

Humana’s Louisiana Medicaid BH Medical Director will oversee our behavioral health (BH) clinical program for Louisiana Medicaid plan members. They will collaborate closely with the Chief Medical Officer (CMO) to integrate the day-to-day administration and strategic management of behavioral and physical health services, including utilization management (UM), quality improvement, and value-based payment programs. The BH Medical Director will be based in Louisiana and will also lead the development of new products and services in Humana’s Medicaid BH delivery model.

Responsibilities

  • Lead major clinical and quality management components of Humana’s BH services
  • Oversee, monitor, and assist with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of Prior Authorization, clinical appropriateness of use, and step therapy requirements for the use of stimulants and antipsychotics for all Enrollees under the age of eighteen (18); consultations and clinical guidance for contracted Primary Care Providers (PCPs) treating behavioral health‐related concerns not requiring referral to behavioral health specialists;
  • Develop comprehensive care programs for the management of youth and adult behavioral health concerns typically treated by PCPs, such as ADHD and depression;
  • Develop targeted education and training for contracted PCPs to screen for mental health and substance use disorders using evidence‐based tools (e.g., AUDIT‐C, PHQ‐9 and GAD‐7), perform diagnostic assessments, provide counseling and prescribe pharmacotherapy when indicated, and build collaborative care models in their practices;

Your Skill Set

  • Physician with a current, unencumbered Louisiana-license as a physician
  • Board-certified in psychiatry
  • Knowledge of the managed care industry
  • Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, UM, discharge planning and/or home health or rehab


Posted September 22, 2021