Medical Director, BH Children's Services
2 days ago
Rochester
At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Medical Director, Behavioral Health Children's Services, to join #TeamMVP. If you have a passion for clinical excellence and innovation, Systemic Change and Policy Leadership, and team empowerment and collaboration this is the opportunity for you. What's in it for you: • Growth opportunities to uplevel your career, • A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team, • Competitive compensation and comprehensive benefits focused on well-being, • An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace. Qualifications you'll bring: • Licensed to practice medicine in New York State., • Board Certified in child and adolescent psychiatry., • Minimum of five years of experience working with children in BH managed care settings or BH clinical settings (at least two years must be in a clinical setting). Previous experience as a medical director in a managed care/health plan is desirable., • Individuals must understand various levels of care within NYS addiction and mental health services including knowledge of NYS child serving systems., • Experience with critical review in clinical scenarios is desirable., • Knowledge of and experience with NCQA requirements and HEDIS reporting is desirable., • Strong organizational, communication, and writing skills for function in a highly matrixed environment are essential, • Ability to communicate effectively with physicians in practice and facility staff is essential., • Travel throughout MVP Health Care's Service area is required., • Ability to effectively use the computer is essential., • Ability to critically evaluate and research the medical literature is essential., • Curiosity to foster innovation and pave the way for growth, • Humility to play as a team, • Commitment to being the difference for our customers in every interaction Your key responsibilities: • The medical director provides clinical expertise and timely first and second level clinical determinations based on MVP's policies/procedures, state and federal guidelines, national accreditation standards, benefits interpretations, and other medical necessity criteria as necessary., • Conducts pediatric reviews. Lead's MVP's efforts to collaborate in person and virtually with behavioral health network providers and facilities around clinical determinations, policy interpretation, sharing of leading indicator and quality data., • Partners with other leaders and executives to represent behavioral health and integrated health programming to state, federal and other regulators as needed., • Identifies and implements initiatives in collaboration with other senior leaders to promote appropriate care quality, service utilization, medication utilization and adherence, care management, and cost control., • Through matrixed leadership supports other key stakeholders such as sales and marketing, quality, operations, and others. Supports and communicates effectively with MVPs Quality Improvement, Pharmacy, Health Promotions, and Disease Management Programs., • Actively participates in MVP training and medical directors' meetings and conference calls. Provides coverage outside of normal business hours on a rotational basis., • It is preferred the applicant is in NYS but not a must; location near one of MVPs administrative locations preferred (Schenectady, Rochester, Tarrytown)., • Performs other duties as assigned., • Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer. Where you'll be: Virtual, preferably in Schenectady, NY Pay Transparency MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role. We do not request current or historical salary information from candidates. MVP's Inclusion Statement At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration. MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications. To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at .