Senior Medical Director, Behavioral Health

• Leads and manages a team of medical directors and behavioral health clinicians responsible for prior authorization, inpatient concurrent review, discharge planning, care management, and interdisciplinary care team activities across a designated multi-state region.
• Provides psychiatric leadership and clinical expertise for utilization management, case management, and integrated behavioral health/chemical dependency programs; collaborates with regional and enterprise leadership to standardize policies and procedures.
• Recruits, hires, trains, mentors, and develops medical director staff and team members as needed.
• Ensures authorization decisions are rendered by qualified personnel without influence from fiscal or administrative incentives, in compliance with regulatory and accreditation standards.
• Analyzes regional data to identify behavioral health cost-savings opportunities, quality improvements, and utilization trends (e.g., prior authorizations, outlier management).
• Facilitates regional medical necessity reviews, cross-coverage, and responses to state-specific regulatory inquiries, complaints, or requests for proposals (RFPs).
• Contributes to the development and implementation of behavioral health medical policies, peer review processes, provider education, and contract reviews.
• Represents the organization in regional stakeholder engagements, including state regulators, providers, and advocacy groups.
• Conducts peer reviews and supports fraud, waste, and abuse mitigation efforts.

• Doctor of Medicine (MD) or Doctor of Osteopathy (DO), with board certification in Psychiatry or a related behavioral health specialty.
• Medical license in at least one state within the assigned region. License must be active and unrestricted in state of practice. 
• At least 8 years of relevant experience, including clinical practice in behavioral health and at least 3 years as a medical director in a managed care setting supporting utilization management and quality initiatives.
• At least 3 years management/leadership experience. 
• Demonstrated experience in multi-state or regional operations, such as standardizing utilization management policies across health plans or navigating varied state Medicaid/Medicare regulations.
• Working knowledge of national, state, and local laws; regulatory requirements (e.g., NCQA, HEDIS); and evidence-based clinical criteria for behavioral health.
• Proven ability to lead in a highly matrixed organization, build consensus, and make strategic decisions.
• Strong verbal and written communication skills, with proficiency in Microsoft Office suite and applicable clinical software systems.

• Eligibility for multi-state licensure. 5+ years in behavioral health-specific managed care leadership.
• Experience with value-based contracting, fraud/waste/abuse mitigation, integrated behavioral-physical health services, or tools such as MCG/InterQual guidelines and PEGA systems.
• Certifications in healthcare management (e.g., CPE) or advanced degrees (e.g., MBA).

Pay Range: $214,132 - $417,557 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.