Behavioral Health Medical Director

CareSource

Behavioral Health Medical Director responsible for patient safety with a focus on safe prescribing. Leading clinical policy development and quality improvement initiatives in a healthcare organization.

Posted 7/8/2026full-timeRemote • 🇺🇸 United StatesLead💰 $195,200 - $341,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical leadership, evidenced-based policy development, and quality improvement initiatives within behavioral health. Proficient in safe prescribing practices and regulatory compliance, with a strong focus on patient safety and care management.

Highest-signal resume keywords

Medical Degree (MD or DO)Residency Training in PsychiatryClinical Practice ExperienceSafe Prescribing ExperienceManaged Care Medical Review Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Policy DevelopmentQuality Improvement InitiativesUtilization ManagementCase Management ActivitiesRegulatory ComplianceClinical ConsultationData AnalysisFraud InvestigationAccreditation ReviewMember Safety Activities

Soft Skills

CollaborationTrainingCommunicationLeadershipGuidance

Industry Keywords

Behavioral HealthClinical StandardsQuality StandardsMarket StrategyProvider RelationsCommunity Collaboration

About the role

Key responsibilities & impact

Assume responsibility for the overall safety of patients with a BH diagnosis, with a special focus on safe prescribing
Serve as the clinical lead in developing and implementing evidenced-based clinical policies and practices
Participate in regulatory/accreditation reviews
Assume key role in quality improvement initiatives, case management activities and member safety activities
BH coverage determination for utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting
Oversight and quality improvement activities associated with case management activities
Provide guidance to BH orientation and network development/recruitment in conjunction with provider relations
Assist in the review of utilization data to identify variances in patterns, and provide feedback and education to MCP staff and providers as appropriate
Represent CareSource as the primary clinical liaison to members, providers and State agencies
Support of regulatory and accreditation functions and compliance for all programs
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
Community collaborative participation
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
Support staff by providing training, clinical consultation, and clinical case review for members including Medical Advisement meetings
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 three (3) years of clinical practice experience is required
Experience in safe prescribing is required
Managed care medical review/medical director experience is preferred

Benefits

Comp & perks

Health insurance
Retirement plans
Paid time off
Flexible work arrangements
Bonuses
Substantial and comprehensive total rewards package