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Behavioral Health Medical Director Associate

Company: Cambia Health Solutions
Location: Portland
Posted on: January 17, 2020

Job Description:


Associate Medical Director Behavioral Health

Portland, OR; Seattle, WA; Tacoma, WA

At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, and Accountability. These values are not just words on paper - we live them every day.


As the Behavioral Health Associate Medical Director, you will appliy medical expertise to help ensure our members receive quality, cost effective clinical care. You will support development and communication of medical policies and clinical programs and work with clinical staff on case management reviews and provide peer-to-peer consultations with providers. May participate on clinical project teams.


* Provides clinical consulting to staff on behavioral health member cases and broader behavioral health trends to ensure members receive quality, cost effective care.

* Conducts high-quality member case reviews and peer-to-peer consultations with providers.

* Communicates with a variety of internal or external stakeholders to promote understanding of care management, utilization management and quality programs.

* Participates on various teams to provide clinical input on medical policy reviews and development and may participate on committees that develop programs impacting clinical interventions, utilization management and case management.

* Stays abreast of industry, medical and technology trends. Identifies and communicates new opportunities that would enhance outcomes and the reputation of the organization.

Minimum Requirements:

* Solid understanding of behavioral health continuum of care, treatment protocols, and evidence-based standards for both mental health and substance use disorders.

* Demonstrated competency working with hospitals, provider groups, or integrated delivery systems to effectively manage patient care to improve outcomes.

* Passion for population health and healthcare transformation.

* Strong communication, influencing and facilitation skills with internal staff and external stakeholders, including the ability to resolve issues and seek optimal outcomes.

* General knowledge of the health insurance industry, state and federal regulations, provider reimbursement methods and evolving accountable care and payment models.

* Detail-oriented with orientation to the application of data in managing health and quality outcomes. Ability to effectively utilize systems and technology.

* Demonstrated ability to effectively build relationships, demonstrate empathy and work as part of a team.

Normally to be proficient in the competencies listed above:

* The Associate Medical Director would have a MD or DO degree, at least 3 years clinical experience, or equivalent combination of education and experience.

* Currently licensed as a Psychiatrist in one or more of the 50 states.

* Board-certification by the American Board of Psychiatry & Neurology in General Psychiatry.

* Strong preference for completion of Child & Adolescent Psychiatry Fellowship and/or Addiction Psychiatry Fellowship.

* Qualification by training and experience to render clinical opinions about medical conditions, procedures, and treatments under review.


Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.

Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.

If you re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.

Keywords: Cambia Health Solutions, Portland , Behavioral Health Medical Director Associate, Healthcare , Portland, Oregon

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