Behavioral Health Medical Director Job at CVS Health (Work at Home)

Associate Medical Director of PACE

Join HopeWest, a non-profit healthcare organization, as their next Associate Med...

Location

United States , Grand Junction

Salary:

212000.00 - 234000.00 USD / Year

B.E. Smith

Expiration Date

Until further notice

Requirements

MD/DO is required
A minimum of five years of clinical experience is required
A minimum of five years of supervisory experience is strongly preferred
Previous PACE experience is strongly preferred
Controlled substance license with current DEA license number
Eligible or currently possess a Medicare/Medicaid NPI number

Job Responsibility

Lead clinical operations for approximately 222+ PACE participants, overseeing their primary care needs and acts as the expert in their medical care
Help to oversee a team of Nurse Practitioners and will work in collaboration with RNs, CNAs, PT/OT, Managers, and IDT
Focus on ongoing clinical initiatives including care plans, behavioral health initiatives, and case reviews
Foster trust through strong staff relationships, assess team dynamics, identify and remove barriers, leverage data to drive decisions, and provide recommendations for improvement and positive change
Clinical oversight related to workflow development, fall risks, committee reviews, finances/invoices and some pharmacy workflows

What we offer

Health insurance coverage
Retirement benefits
Bonuses

Fulltime

Behavioral Health Medical Director

The Behavioral Health (BH) Medical Director leverages clinical expertise to prov...

Location

United States

Salary:

189600.00 - 237000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

MD or DO degree and 5+ years of direct clinical patient care experience post residency or fellowship including behavioral health environments
Current and ongoing Board Certification in psychiatry by the American Board of Psychiatry and Neurology (ABPN) required
Additional Board Certification in Child and Adolescent Psychiatry or Addiction Medicine
A current and unrestricted license in the state of California and willing to obtain additional license(s)
No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
Minimum 5 years of Utilization Review or Hospital experience required
Minimum 3 years of compliance related experience preferred
Managed Care experience preferred in utilization review and case management
Expertise in behavioral health case management, utilization review and telehealth delivery
Ability to design and evaluate behavioral health programs, integrating evidence-based practices and holistic wellbeing approaches

Job Responsibility

Oversee and participate in behavioral health case management, including utilization review, telephonic care, and urgent response coordination for behavioral health and substance use disorder needs
Conduct reviews for medical necessity for prior authorization, continued stay, and post-service claims, applying medical policy, guidelines, and current research
Integrate behavioral health screening and interventions within physical health case management programs, utilizing standardized tools (e.g., PHQ2, PHQ9) and ensuring appropriate referrals
Support and monitor virtual behavioral health services, ensuring access, privacy, and continuity of care for all age groups, including children, teens, and adults
Supervise and provide clinical oversight for residential and outpatient behavioral health programs, including partial hospitalization and intensive outpatient services, with an emphasis on family engagement and comprehensive discharge planning
Lead the development and implementation of comprehensive behavioral health strategies, including program design, staff education, and quality improvement initiatives
Maintain compliance with national guidelines (e.g., MCG, InterQual, specialty college recommendations) and regulatory requirements (federal, state, ERISA) specific to behavioral health
Oversee the negotiation and implementation of cost management strategies to affect quality outcomes, reflecting data in monthly case management reviews
Participate in grievance and appeals processes, including escalated behavioral health issues
Collaborate with the VP of Care Management to establish work procedures and processes that support company and departmental standards, procedures, and strategic directives

What we offer

Comprehensive medical and dental coverage through our own health solutions
Mental health support and wellness programs designed by experts who get it
Flexible work arrangements that fit your life
Retirement planning support to help you build real wealth for the future
Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
Professional development opportunities and clear career progression paths
Mentorship from industry leaders who want to see you succeed
Learning budget to invest in skills that matter to your future
Unlimited PTO policy

Parttime

New

Clinical Case Manager Behavioral Health

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Work at Home

Salary:

60522.00 - 129615.00 USD / Year

CVS Health

Expiration Date

March 27, 2026

Requirements

Minimum 3 years of direct clinical practice experience post master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility
Active and unrestricted Independent Behavioral Health clinical license in the state of Ohio. ( Ex - LISW, LPCC, LCSW)
Must be resident of Ohio State
Willing and able to travel up to 10% anywhere in the state of Ohio as needed. (staff meetings, Health Forums etc)
Eligible for mileage reimbursement and reliable transportation is required
Masters degree in Behavioral Health/Social service or human services field required. Independently Licensed preferred

Job Responsibility

Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues
Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated
Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services
Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits
Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives
presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes
Identifies and escalates quality of care issues through established channels
Ability to speak to medical and behavioral health professionals to influence appropriate member care

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Fulltime

Integrated Care Manager

Responsible for promoting continuity of care through a collaborative process tha...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications
Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).

Job Responsibility

Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan
Answer a diverse and high volume of health insurance related customer calls on a daily basis
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests
Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
Maintain complete and accurate records per department policy
Demonstrate ability to apply plan policies and procedures effectively

Fulltime

Medical Director of Population Health

The Medical Director of Population Health plays a strategic role in improving ut...

Location

United States , Macon

Salary:

Not provided

Advocate Health Care

Expiration Date

Until further notice

Requirements

License/Registration/Certification: Appropriate State Physician License
Certification: Appropriate board certification by American Board of Medical Specialties
Minimum of 7 years experience in the clinical practice of medicine
Minimum of 3 years experience in medical management or academic medicine
Exhibits a high level of professionalism, personal integrity, fortitude and approach to problem-solving
Models exemplar leadership behaviors
Possesses exceptional written and verbal communication and interpersonal skills
Committed to service of patients, colleagues and team members
Demonstrates strong leadership and effective team-building skills
Skilled in the ability to conduct difficult conversations, while effectively coaching and mentoring colleagues

Job Responsibility

Provide leadership and mentorship to Physician members in achieving High Performing Network priorities of quality, efficiency and engagement
Collaborate with EPH teams on quality, CMD, utilization and other performance initiatives
Maintain a close working relationship with stakeholders including aligned PCPs and specialists, SE quality team, medical group leadership including specialty medical directors, site medical directors, primary care service line
Attend, and lead when called on, population health and CGHN meetings concerning quality, utilization, finance, performance, and any administrative meetings as necessary
Identify and develop action plans to address performance improvement gaps within CGHN
Actively engage in financial review and planning for the CGHN finances and value-based lives membership
Identify potential new leaders and collaborate with CGHN leadership on succession planning for CGHN Board and other CGHN committees and activities
The Clinical leader supporting different population health teams supporting CIN physicians within CGHN

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Clinical Psychologist

As a Clinical Psychologist, you will be instrumental in setting the tone for a p...

Location

United States

Salary:

Not provided

Solace

Expiration Date

Until further notice

Requirements

Active, unrestricted licensure as a psychologist (PhD or PsyD) in the state of California and/or PSYPACT authorization
3+ years of independent practice
Deep understanding of the DSM-5 diagnostic guidelines
Experience with patients who have medical complexity in addition to behavioral health needs
A willingness to give feedback and practice in an iterative setting
A willingness to roll up your sleeves and help out beyond direct patient care
Prior startup experience is a plus
prior experience working at a tech-forward clinical startup is a massive plus
comfort working autonomously is a necessity
Applicants must be based in the United States.

Job Responsibility

Perform intake evaluations in accordance with Solace’s guidelines, gathering clinical information including a patient’s chronic conditions, behavioral health conditions, and health-related social needs
Maintain accurate, complete, timely, and compliant documentation
Work closely with the Director of Behavioral Health to provide feedback about processes and procedures, and work to establish new processes and best practices
Participate in interdisciplinary meetings with clinical operations, product, and other verticals in the organization
Operate as a behavioral health subject matter expert on the team, supporting Solace patient advocates who are working with behaviorally complex patients
Provide input on platform enhancements, clinical decision support, and other tools required to enable this new service

Fulltime

System Director, Behavioral Health - Inpatient

Baptist Health is hiring a System Director, Behavioral Health - Inpatient for bo...

Location

United States , Jacksonville

Salary:

Not provided

Baptist Health (Florida)

Expiration Date

Until further notice

Requirements

Bachelor's Degree - Nursing
Licensed Registered Nurse
3-5 Years Nursing Leadership Experience
3-5 Years Nursing Management Experience

Job Responsibility

Direct, oversee and evaluate nurses, therapists, and support personnel on the adult and pediatric inpatient and partial hospital behavioral health units
Establish annual objectives and long-term goals for behavioral health in collaboration with hospital entities
Organize and coordinate admission and patient care procedures, working hand-in-hand with the psychiatry teams and the emergency department
Develop and enforce policies aiming for legal compliance and high quality standards
Control budgets and monitor expenditures
Resolve personnel and operational issues and deficiencies as needed
Oversee electronic medical record procedures and updates
Collaborate with other departments and professionals to streamline operations
Report to the Administrator of Behavioral Health

Fulltime

Lead ABA Medical Biller

A Behavioral Health Company in Long Beach is in the need of a Lead ABA Medical B...

Location

United States , Long Beach

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Lead ABA Medical Biller with DMH experience
must have behavioral health experience

Job Responsibility

Supervise and provide daily guidance to billing staff, ensuring adherence to established procedures
Conduct training, coaching, and performance evaluations for team members, supporting their growth and attention to detail
Review billing documentation and workflows to ensure accuracy and compliance with established protocols
Address claim denials by analyzing monthly revenue reports and implementing corrective measures
Collaborate with Quality Assurance staff to update administrative sections of client files as needed
Process electronic billing efficiently, ensuring clean and accurate claims using available technology
Reconcile billing reports for the Department of Mental Health and Behavioral Health Services, ensuring compliance with agency standards
Partner with the Billing Director to implement new procedures and provide operational feedback
Organize and facilitate departmental meetings and training sessions to improve team performance
Attend required meetings and training sessions to stay updated on internal and external systems relevant to billing operations

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Behavioral Health Medical Director

CVS Health

Location:
United States , Work at Home

Category:
-

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
March 04, 2026

Expiration:
March 31, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Behavioral Health Medical Director

Associate Medical Director of PACE

Behavioral Health Medical Director

Clinical Case Manager Behavioral Health

Integrated Care Manager

Medical Director of Population Health

Clinical Psychologist

System Director, Behavioral Health - Inpatient

Lead ABA Medical Biller

Behavioral Health Medical Director

CVS Health

Location:United States , Work at Home

Category:-

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:March 04, 2026

Expiration:March 31, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Behavioral Health Medical Director

Associate Medical Director of PACE

Behavioral Health Medical Director

Clinical Case Manager Behavioral Health

Integrated Care Manager

Medical Director of Population Health

Clinical Psychologist

System Director, Behavioral Health - Inpatient

Lead ABA Medical Biller

Location:
United States , Work at Home

Category:
-

Contract Type:
Not provided

Job Posted:
March 04, 2026

Expiration:
March 31, 2026