Humana

Chief Psychiatrist - Behavioral Health Medical Director

Illinois, United States

Not SpecifiedCompensation
Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, Behavioral HealthIndustries

Requirements

Candidates must be a physician with a current, unencumbered Illinois license, board-certified in psychiatry. They must reside and work in Illinois, with over 5 years of clinical experience in behavioral health and knowledge of the managed care industry. Experience in leading teams focused on quality management, utilization management, discharge planning, home health, or rehab is also required. Familiarity with Illinois-based behavioral health organizations and Medicaid Managed Care clinical or behavioral health leadership experience is preferred.

Responsibilities

The Chief Psychiatrist will oversee the behavioral health clinical program for Illinois FIDE members, integrating behavioral and physical health services. Responsibilities include leading clinical and quality management components, overseeing psychopharmacology PBM activities, developing care programs for adult behavioral health concerns, and creating educational materials for primary care providers. The role involves coordinating with the Medical Director for integrated health services, overseeing the Quality Management and Utilization Management programs, and leading BH policy development in Illinois. The Chief Psychiatrist will ensure compliance with federal and state laws, collaborate with provider relations, build relationships with stakeholders, and represent Humana at public forums. They will also maintain compliance with BH-related contract requirements and collaborate with population health teams on developing strategies to address BH needs.

Skills

Behavioral Health
Clinical Program Management
Utilization Management
Quality Improvement
Psychopharmacology
Prior Authorization
Collaborative Care Models
Mental Health
Substance Use Disorders
Medical Director
Strategic Management

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

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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