Manager, Behavioral Health
Imagine PediatricsSalary not specified
Full Time
Senior (5 to 8 years)
Not SpecifiedCompensation
Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Medicaid, Behavioral HealthIndustries
Requirements
- Physician with a current or ability to obtain unencumbered Illinois license and be board-certified in psychiatry
- 8+ years clinical experience working in behavioral health
- Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, UM, discharge planning and/or home health or rehab
- Must reside in Illinois, or a bordering state (Indiana, Wisconsin and Iowa) and be willing to report to the market office in IL as needed for trainings/meetings
- Preferred Qualifications
- Familiarity with Illinois-based BH organizations
- Medicaid Managed Care clinical or behavioral health leadership experience
- Reside near the border of Illinois in Indiana, Wisconsin and Iowa
Responsibilities
- Leads clinical and quality management components of Humana’s BH services
- Oversees, monitors, and assists with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of prior authorization, clinical appropriateness of use; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health‐related concerns not requiring referral to behavioral health specialists
- Develops comprehensive care programs for the management of adult behavioral health concerns typically treated by PCPs, such as ADHD and depression
- Develops targeted education and training for contracted PCPs to screen for mental health and substance use disorders (SUD) using evidence‐based tools (e.g., AUDIT‐C, PHQ‐9 and GAD‐7), performs diagnostic assessments, provide counseling and prescribe pharmacotherapy when indicated, and build collaborative care models in their practices
- Coordinates with the Medical Director to integrate the administration and management of behavioral and physical health services
- Oversees, monitors, and assists with effective implementation of the Quality Management (QM) program; and work closely with the Utilization Management (UM) of services and associated appeals related to adults with mental illness and/or SUD
- Leads BH policy development in Illinois, driving implementation, oversight, and accountability for both Humana internal and external stakeholders including but not limited to the Department Healthcare and Family Services (HFS), Department of Human Services (DHS), and the Department of Public Health (IDPH)
- Adheres to and complies with federal and state laws and programmatic requirements
- Collaborates with Provider relations personnel to ensure high-quality and appropriate care delivered through the BH Provider network
- Establishes and maintains relationships with Providers, advocates, and other key Illinois stakeholders by maintaining open and ongoing communications; represents Humana at public forums and engagement opportunities
- Maintains compliance with BH-related Contract requirements and attends oversight committee meetings to ensure appropriate procedures are adhered to within Humana and within care delivery
- Collaborates closely with corporate and local population health teams in developing programs and strategies to address BH needs at a population health level
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
Is this a remote position or does it require being based in a specific location?
The Chief Psychiatrist will be based in Illinois.
What are the key responsibilities of the Chief Psychiatrist role?
The role involves leading clinical and quality management of behavioral health services, overseeing psychopharmacology PBM activities, developing care programs for conditions like ADHD and depression, coordinating with PCPs, and ensuring compliance with state requirements.
What salary or compensation is offered for this position?
This information is not specified in the job description.
What is the work environment or company culture like at Humana for this role?
This information is not specified in the job description.
What makes a strong candidate for the Chief Psychiatrist position?
A strong candidate would have expertise in behavioral health clinical leadership, experience in psychopharmacology, utilization management, quality improvement, and the ability to collaborate with providers, stakeholders, and state departments in Illinois.
Humana
Health insurance provider for seniors and military
About Humana
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.
Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees