Medical Director – Behavioral Health

Aetna, a CVS Health company has an outstanding opportunity for a Medical Director – Behavioral Health. Ready to take your career to the next level with a Fortune 6 company?

Roles and responsibilities:

• Oversee and be responsible for all Behavioral Health activities
• Oversight of coordination activities with KDADS
• Shall work closely with the behavior supports director and other medical officers to ensure the delivery of holistic and integrated person-centered care.
  • Provide strategic oversight and leadership for all behavioral health activities within the health plan.
  • Serve as the subject matter expert on behavioral health for Aetna Better Health of Kansas, ensuring compliance and alignment with state regulations and expectations.
  • Lead and coordinate efforts with the state and other health plan colleagues to promote integrated care models.
  • Oversee coordination activities with the state, ensuring effective collaboration and adherence to regulatory requirements.
  • Work closely with health plan leadership, the Chief Medical Officer, other Medical Leadership, Pharmacy Director, clinical staff (including those in utilization management, care management, quality management), and colleagues within network and provider relations, to enhance the delivery of holistic and integrated care.
  • Contribute to the development and implementation of policies and procedures that support the health plan's objectives and comply with state guidelines.
  • Advocate for and implement innovative approaches to behavioral health care, promoting evidence-based practices that enhance patient outcomes.
  • Support duties as required regarding utilization management of the service benefit and pharmacy benefit within the state health plan and additional duties as assigned.
  • Actively participate in continuous improvement activities, development and monitoring of SAI initiatives, and other activities that support quality of care and total cost of care oversight.
  • Serve as a key health plan external facing liaison, regarding behavioral health initiatives, programs, and projects with state regulators, providers, vendors, and community organizations.
  • Provides guidance and/or represents the Health Plan in all state fair hearings for services that are behavioral health related.

Required Qualifications

• Board certified psychiatrist and addictionologist (or addictions experience approved by the State in writing),
• Licensed physician in Kansas and reside in Kansas.
• Has at least five (5) years combined experience in mental health and SUD services.

Education

• M.D. or D.O., Board Certification in Psychiatry including post graduate direct patient care experience