Enterprise Medical Director – Behavioral Health

CareSource

Enterprise Medical Director overseeing patient safety and clinical policies in behavioral health for CareSource. Leading initiatives in community collaboration, compliance, and provider education in Ohio.

Posted 4/16/2026full-timeRemote • Ohio • 🇺🇸 United StatesLead💰 $195,200 - $341,600 per yearWebsite

About the role

Key responsibilities & impact

Responsible for the overall safety of patients with a BH diagnosis, with a special focus on safe prescribing
Support Ohio Behavioral Health Market team program design and development and strengthening community collaboration
Supervise part time Behavioral Health Medical Directors
Serve as the clinical lead in developing and implementing evidenced based clinical policies and practices
Assume key role in quality improvement initiatives, case management activities and member safety activities
Support of regulatory and accreditation functions (eg. CMS, State, NCQA and URAC) and compliance for all programs
Provide provider education, training, data sharing, performance evaluations and orientation to the plan
Participate in the development, implementation and revision of the clinical care standards and practice guidelines ensuring compliance with nationally accepted quality standards
Participate in the development, implementation and revision of the Quality Improvement Plan and corporate level quality initiatives
Collaborate with market/product leaders to help define market strategy
Assist in the review of utilization data to identify variances in patterns, and provide feedback and education to MCP staff and providers as appropriate
Participate in the evaluation and investigations of cases suspected of fraud, abuse, and quality of care concerns
Provide cross-coverage for other Medical Directors and/or markets, as needed
Provide prior authorization medical reviews, consultation, and clinical review services
Conduct clinical reviews for designated CareSource members
Identify utilization management trends and take appropriate action
Support market provider network development and maintenance Clinical Appeals
Participate in peer-to-peer discussions
Support staff by providing training, clinical consultation, and clinical case review for members
Perform any other job duties as requested

Requirements

What you’ll need

Completion of an accredited Medical Degree program as a medical doctor (MD) or Doctor of Osteopathic (DO) medicine is required
Successful completion of a residency training program, in psychiatry is required
Minimum of five (5) years of clinical practice experience
Clinical SUD/MAT experience is preferred
Managed care medical review/medical director experience is preferred
Bachelor's or Master's degree in Business Administration, Operational Excellence, Healthcare Administration or Medical Management is preferred
Basic Microsoft Word skills
Current, unrestricted license to practice medicine in state of practice as necessary to meet regulatory requirements is required
Board Certification in psychiatry is required
Re-certification, as required by specialty board, must be maintained (exceptions may be granted by Chief Medical Officer)
MCG Certification is required or must be obtained within six (6) months of hire

Benefits

Comp & perks

Bonuses tied to company and individual performance
Substantial and comprehensive total rewards package

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical practicepsychiatryclinical SUD/MAT experiencemanaged care medical reviewquality improvement initiativesutilization managementevidence-based clinical policiescase managementclinical review servicesprovider education

Soft Skills

leadershipcollaborationcommunicationtrainingsupervisionproblem-solvinganalytical skillsperformance evaluationconsultationcross-coverage

Certifications

Medical Degree (MD or DO)Board Certification in psychiatryMCG Certificationcurrent medical licenseresidency training in psychiatry