Pennsylvania Licensed Behavioral Health Medical Director

A company is looking for a Behavioral Health Medical Director to focus on adult psychiatric cases related to substance abuse. Key Responsibilities Conduct coverage reviews and render determinations based on member plan benefits and review policies Document clinical review findings and ensure compliance with policies and regulatory standards Engage with providers through peer-to-peer discussions and support organizational accreditation efforts Required Qualifications 5+ years of clinical experience post-residency, including inpatient and outpatient care 3+ years of experience in managed care, utilization review, or quality management MD or DO degree with appropriate Board certification Current unrestricted licensure in Pennsylvania as an MD or DO Current coverage, or eligibility for, medical liability insurance