Associate Medical Director Behavioral Health or Utilization Management Medical Director (Behavioral Health)

Location: Work from home within Oregon, Washington, Idaho, or Utah; candidates must be located in one of these four states.

Expected annual hiring range: $217,600–$294,400 for the Associate Medical Director level; $238,850–$323,150 for the Medical Director level. Full salary ranges and bonus targets vary by level and location.

Company

hirify.global is a purpose-driven health care organization focused on creating a person-focused and economically sustainable health care system.

What you will do

• Lead clinical oversight for behavioral health utilization management across health plan lines of business.
• Complete behavioral health utilization reviews, including prior authorizations, appeals, and post-service reviews.
• Develop behavioral health medical policies, programs, goals, and long-range plans.
• Oversee operational policies and standards, monitor utilization and outcomes, and implement process or system improvements.
• Provide clinical expertise and medical guidance to staff, providers, and internal stakeholders.
• Collaborate on policy reviews, quality improvement, industry trends, and initiatives to reduce medical cost trends.

Requirements

• MD or DO degree and an active, unrestricted medical license in one or more of Oregon, Washington, Idaho, or Utah.
• Board certification in general psychiatry or child psychiatry; certification in both is preferred.
• At least three years of clinical experience.
• Two years of health plan medical utilization management and/or case management experience.
• Experience providing clinical opinions, conducting medical case reviews, and working with hospitals, provider groups, or integrated delivery systems.
• Strong communication, facilitation, leadership, relationship-building, and data-driven decision-making skills.

Nice to have

• Knowledge of health insurance operations, state and federal regulations, parity legislation, provider reimbursement, and accountable care models.
• Experience with AI tools and technologies for professional productivity and decision-making.

Culture & Benefits

• Part-time, non-benefited position capped at 12 hours per week.
• Purpose-driven work focused on improving health care and the experience of people with mental health issues.
• Work-from-home setup requires a wired, non-satellite or non-cellular internet connection with minimum upload and download speeds.
• New hires must use a personal mobile device to configure required multi-factor authentication.
• A background check is required.