Part‑time Behavioral Health Medical Director (20 hrs/week)

About the role

A reputable organization is seeking a dedicated Behavioral Health Medical Director to lead adult psychiatric case reviews focused on substance‑use disorders. This part‑time position offers a flexible schedule of 20 hours per week, Tuesday through Friday, during standard Eastern Standard Time business hours.

Key responsibilities

• Conduct coverage reviews for 12‑15 cases per 4‑hour shift, applying internal policies, regulatory standards, and accreditation requirements.
• Document clinical findings and decisions in compliance with policy and regulatory guidelines.
• Utilize Interqual and ASAM guidelines to inform coverage determinations.
• Engage in peer‑to‑peer discussions with providers when needed.
• Interpret benefit language and educate providers on plan benefits and medical policies.
• Make coverage determinations for services that do not meet medical necessity criteria.
• Assess appeals and grievances, ensuring independent review at each level.
• Support accreditation and regulatory review processes across prior authorization, concurrent review, and case management programs.

Required profile

• MD or DO with current unrestricted Pennsylvania licensure.
• Board certification and 5+ years of clinical experience post‑residency in inpatient and outpatient settings.
• 3+ years of experience in managed care, utilization review, or quality management.
• Current medical liability insurance coverage or eligibility.

Required skills

• Proficiency with Interqual guidelines.
• Proficiency with ASAM guidelines.

What we offer

• Competitive hourly rate of $120‑$150.
• Flexible part‑time schedule with no weekend coverage.
• Opportunity to influence clinical coverage decisions and quality initiatives.