About Texas Children's Hospital
Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org
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We are searching for a Medical Director for Behavioral Health – someone who works well in a fast-paced setting. In this position, you will be responsible for establishing health plan and medical policies. You will provide guidance to areas within departments of our client’s organization; oversee assigned functions of the health plan, provide support, education, and consultation to our client’s staff and physicians, regarding resource utilization, managed care, disease management, and continuity of care issues.
Think you’ve got what it takes?
- Works with the CMOs, oversees and provides recommendations to continuously improve the implementation of medical management programs as outlined in the policy and procedures
- Provides crucial clinical input to disease management and care management programs
- Oversees the clinical professional review of medical and/or behavioral health care by the registered nurses employed by our client and ensures regulatory compliance
- Works with the CMOs and Medical Director for Utilization Management and provides input into the development of medical care guidelines for utilization of behavioral health services
- Approves medical care based upon guidelines set-up and approved by the CAAC, using appropriate independent clinical judgement and not adversely influenced by fiscal management decisions
- Ensures that our client’s UM Program reflects current philosophies in managed care and the stated values and goals of our client
- Works with the CMOs to develop guidelines and ensure office sites and medical records meet the standards for proper behavioral health care
- Participates in other Committees as directed by the CMO’s affecting patient care and medical policy, Baylor teaching programs, and consults on managed care as necessary
- Interacts with and participates in committees and medical functions of outside agencies to include primary HMOs, state and federal agencies, and professional organizations as directed by the CMOs
- Serves as a crucial member of our client’s operating team
- Provides timely and accurate oral and written progress reports at staff meetings and to the CMOs
- Doctor of Medicine (M.D.) required
- TX Medical license
- Board certified in Psychiatry
- 5 years’ healthcare management, managed care, and/or behavioral health experience required
- Residency in psychiatry or child psychiatry training
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