Join Our Dedicated Team in Behavioral Health
As the Director of Behavioral Health Services, you will lead the strategic and operational initiatives for behavioral health care. This role involves navigating complex challenges, requiring a deep analysis of various factors to deliver effective solutions.
You will have the opportunity to create innovative procedures, set productivity targets, and develop new delivery models while ensuring that operations are efficient and aligned with quality care and financial objectives. Your insights into pricing and resource utilization will be critical as you partner with various stakeholders.
Utilizing your medical expertise and judgement, you will evaluate and authorize requested services, levels of care, and sites of service, always prioritizing regulatory compliance. You will leverage diverse resources, such as national clinical guidelines and CMS policies, to inform your decisions.
In this role, you will also engage with external physicians, groups, facilities, and community organizations, supporting regional market initiatives. You will embody Humana's values and contribute to our Bold Goal mission in every aspect of your work.
Your Impact Starts Here
Key Qualifications:
- MD or DO degree
- 5+ years of direct clinical patient care experience post residency or fellowship, preferably in inpatient settings or with Medicare/Medicaid populations
- Current Board Certification in an approved ABMS Medical or ABPN Specialty
- Valid, unrestricted medical license and willingness to obtain additional licenses as needed.
- No current sanctions from Federal or State Governmental organizations.
- Strong verbal and written communication skills.
- Analytical skills and experience in quality and utilization management, case management, discharge planning, or home health services.
Preferred Qualifications:
- Understanding of the managed care landscape, including Medicare Advantage and Managed Medicaid
- Experience with utilization management in medical review organizations
- Familiarity with national guidelines such as MCG® or InterQual
- Specialization in Psychiatry, Internal Medicine, Family Practice, Geriatrics, Hospitalist, or Emergency Medicine
- Advanced degree (MBA, MHA, MPH) and exposure to Public Health and Population Health analytics
- Experience collaborating with Case Managers or Care Managers on complex cases, with awareness of social determinants of health.
- A proactive approach to learning, adapting, and innovating.
Additional Information:
This position typically reports to the Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on the size of the region or line of business.
While this is a remote role, occasional travel to Humana's offices for meetings or training may be required.
Scheduled Weekly Hours: 40
Compensation:
Your starting base pay will range from $223,800 to $313,100 per year, depending on your experience and geographic location. This position is also eligible for a performance-based bonus incentive plan.
Benefits:
Humana offers competitive benefits aimed at promoting overall well-being for you and your family, including medical, dental, vision insurance, 401(k), generous paid time off, disability insurance, and more.
About Humana:
Humana Inc. (NYSE: HUM) is a leading healthcare company committed to making healthcare easier for millions of people, enhancing their quality of life through innovative services and networks.
Equal Opportunity Employer:
Humana does not discriminate in employment decisions based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, disability, or veteran status. We are dedicated to ensuring equality in all employment actions.