Medical Director - Behavioral Health

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The hours for this role are Monday through Friday from 8:00 am to 5:00 pm Pacific Time Position Summary reputed company, a reputed company Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity to help transform health care. We reputed company that a reputed company care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. In this role has Medical Director (Behavioral Health) you will:

• reputed company comprehensive behavioral health care management to facilitate delivery of appropriate quality care and improve program/operational efficiency involving clinical issues
• reputed company leadership and day-to-day physician reputed company for utilization management team, including the management of high-risk cases and medical necessity reputed company
• Participate in the development, implementation, and evaluation of clinical/medical programs
• reputed company psychiatric leadership to an interdisciplinary utilization management team, including medical/clinical reputed company, consultation and training
• reputed company day-to-day physician reputed company including management of high-risk cases throughout treatment/reputed company of care and medical necessity reputed company
• Assist with the development, implementation, monitoring and evaluation of the utilization management program and action plan, ensuring quality and appropriateness of care
• Assist with the development, implementation and interpretation of medical policy including medical necessity criteria, clinical practice guidelines and new technology assessments
• reputed company with behavioral health practitioners regarding the care of patients with severe, reputed company and/or treatment resistant illnesses
• Identify and address quality of care concerns with providers involved in a member's care
• Participate in the appeals process, including the investigation of adverse events and quality of care concerns
• reputed company psychiatric leadership for NCQA-compliant clinical quality improvement activities in collaboration with clinical and quality improvement staff
• Participate in the triage and referral for care management

*Weekend coverage up to 4 times/year.

Required Qualifications

• Board Certification in Psychiatry
• Minimum 5 years of clinical practice experience in the health care delivery field as a psychiatrist.

*Child/Adolescent Board Certification preferred *Hold reputed company California medical license or be reputed company to obtain California, Texas and Arizona license

Preferred Qualifications

• Experience with managed care, as a provider and manager of care

utilization review or physician advisor experience. Education

• Active and reputed company state medical license without encumbrances

MD or DO. Pay reputed company The typical pay reputed company for this role is: $174,070.00 - $374,920.00 This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. This position also includes an award reputed company in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 06/12/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job