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Behavioral Health Medical Services Director

Sunshine State Health Plan
San Francisco, CA Full Time
POSTED ON 1/27/2025 CLOSED ON 2/11/2025

What are the responsibilities and job description for the Behavioral Health Medical Services Director position at Sunshine State Health Plan?

Director of Behavioral Health Medical Services:
The ideal candidate for this position will have a strong background in medical management, quality improvement, and credentialing. As the Director of Behavioral Health Medical Services, you will direct and coordinate medical management, quality improvement, and credentialing functions for our business unit.

Key Responsibilities:
  • Provide medical leadership to ensure timely and quality decision-making in utilization review, quality assurance, and medical review of complex cases.
  • Support effective implementation of performance improvement initiatives for capitated providers, focusing on quality and cost-effectiveness of care.
  • Develop alliances with the provider community through the development and implementation of medical management programs.

Requirements:
  • Medical Doctor or Doctor of Osteopathy degree.
  • Board certification by the American Board of Psychiatry and Neurology is required.
  • A current Florida state medical license without restrictions is also required.
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