Behavioral Health Medical Director
Virginia Premier has retained Morgan Consulting Resources, Inc. to conduct the search for their Behavioral Health Medical Director. This is an outstanding opportunity to be a highly visible member of a dynamic organization. This position will be based in Richmond (Glen Allen), Virginia.
About the company:
Virginia Premier is a non-profit managed care organization, locally owned by VCU Health. While they are headquartered in Richmond, they also have a presence in Bristol, Wise, Richlands, Winchester, Roanoke, Tidewater and Northern Virginia. This enables them to serve vulnerable populations throughout the state. Virginia Premier Health Plan focuses their resources on member services, offering: Virginia Premier Health Plan, a Medicaid Plan; Virginia Premier Elite Plus, a plan for those needing long-term services and supports; and Virginia Premier Elite, a Medicare Advantage Plan. They opened their first Patient-Centered Medical Home in Roanoke, VA in 2014. Please visit their website at www.vapremier.com.
Virginia Premier’s Commitment and Mission Statements:
Commitment: Helping individuals and families find and fund quality healthcare is at the heart of what we do. We fulfill this objective by delivering easy access to doctors, specialists, hospitals, referrals and emergency aid. In doing so, we act as a strong partner for our members in providing for their health and the health of their families.
Mission: Virginia Premier, a managed care organization owned by the Virginia Commonwealth University Medical Center, meets the needs of underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable healthcare.
About the position:
The Behavioral Health Medical Director (BHMD) is responsible for medical management clinical functions including Utilization Management, Quality Improvement, Credentialing and Pharmacy for Behavioral Health and Substance Abuse Disorders. He/She will improve the health care delivery system for effective delivery of behavioral health care and will be the Behavioral Health clinical subject matter expert at Virginia Premier. The BHMD will supervise the Associate Behavioral Health Medical Director in addition to partnering with the CMO as his Behavioral Health partner. The role will have an integral part in the development of Behavioral Health programs for Virginia Premier, developing and implementing strategies for growth. The Behavioral Health Medical Director will be a member of the Virginia Premier Health Quality Utilization Management (HQUM) Committee.
Position Duties and Responsibilities
- Assisting the CMO and Medical Directors in the following activities:
- Behavioral Health Utilization Management
- Behavioral Health Quality Assessment and Improvement activities
- Outreach programs and developing partnership opportunities
- Development of practice and preventive guidelines
- Ensuring regulatory and accreditation compliance
- Serving as a Virginia Premier representative in designated local meetings with managers, provider offices, local and state health care organizations
- Reviewing pharmacy requests and appeals to determine medical necessity
- Monitoring of provider performance
- Recommending departmental improvements
- Resource for Medical Management staff for care coordination and management for ambulatory and inpatient services
- Acting as medical reviewer on appeals
- Demonstrating collaboration with Virginia Premier staff and management to achieve goals and objectives of the department and organization
Required Education and Experience:
- Maintain a Current Unrestricted Virginia Physician License, or the ability to obtain one
- Board Certification in Psychiatry required
- Commitment to Virginia Premier’s clinical programs and mission to serve the Medicaid population
- Ability to work with colleagues and other health care professionals to resolve utilization and quality management issues
- Ability to communicate effectively with health professionals, administrators and staff, both orally and in writing
- Ability to review the medical literature to answer a clinical question
- Minimum of five years clinical experience
- Experience in managed care medical management preferred
Physical health sufficient to meet the ergonomic standards and demands of the position
About Richmond, VA:
Richmond is a city that represents a significant chapter in America’s history, with cobblestone streets, river walks and historical monuments. Originally a colonial settlement, Virginia’s capital is now a thriving hub for culture, shopping and outdoor fun. With lively neighborhoods and a vibrant restaurant scene, Richmond combines big city amenities with southern charm and ease.
If you or someone you know has the qualifications we seek, I’d love to set up a time to talk. Thank you so much for your time.
Julianne Schoepp, Principal
Morgan Consulting Resources, Inc.