Aetna Behavioral Health Medical Director (Child & Adolescent Psychiatrist) in Phoenix, Arizona
Req ID: 44978BR
The Child Medical Director (Behavioral Health) is responsible for performing daily prior authorization for medically necessary services, concurrent review of IP and residential placements, as well as Pharmacy Medical necessity reviews. There is also an opportunity to collaborate with other medical management team members and system partners and stakeholders.
Prior Authorization for medically necessary services.
Concurrent review of inpatient hospital care and residential placements.
Pharmacy prior authorization for medically necessary treatments.
Collaboration with other health care plans and stakeholders such as the Department of Child Safety, the Department of Developmental Disabilities and the Regional Behavioral Health Authority.
-Assist the Children's Medical Administrator with Quality Management.
Three to Five years of experience in the health care delivery system e.g., clinical practice and health care industry. Managed care experience preferred.
Demonstrated appreciation of cultural diversity and sensitivity towards target populations.
Current Board Certification in Child and Adolescent Psychiatry and an unrestricted Arizona Medical License or willingness to obtain an Arizona License.
The highest level of education desired for candidates in this position is a MD
LICENSES AND CERTIFICATIONS
Active Unrestricted Arizona State Medical License Required or willingness to get Arizona State Medical License
Board Certification in Child & Adolescent Psychiatry Highly Desired
Healthcare Management/ is desired
Medical Management/ABMS - Child & Adolescent Psychiatry is desired
Functional - Medical Management/Medical Management - Managed Care/Insurance Clinical Staff/1-3 Years
Functional - Clinical / Medical/Concurrent review / discharge planning/1-3 Years
Functional - Clinical / Medical/Direct patient care (hospital, private practice)/4-6 Years
Functional - Medical Management/Medical Management - Educator (includes in-service/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/1-3 Years/End User
Benefits Management/Interacting with Medical Professionals/ADVANCED
Benefits Management/Shaping the Healthcare System/ADVANCED
Benefits Management/Understanding Clinical Impacts/ADVANCED
Benefits Management/Supporting Medical Practice/ADVANCED
General Business/Maximizing Work Practices/ADVANCED
Leadership/Collaborating for Results/FOUNDATION
ADDITIONAL JOB INFORMATION
This is an opportunity to be a part of the Children's System of Care Redesign in Maricopa County working in a progressive integrative team of medical and behavioral health experts. You will have the opportunity to directly impact the care our members receive and influence the quality of behavioral health services in Maricopa County.
This position requires someone who is highly internally motivated and takes initiative. Must be able to work independently and be efficient with time management. Simultaneously, the candidate must demonstrate collaborative and teamwork traits- be able to clearly and effectively communicate with other clinicians, colleagues and community stakeholders. The work environment is fast-paced: candidate must be flexible. Confidence is desired; tempered by ability to absorb and incorporate feedback.
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
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Job Function: Health Care