Medical Director for Mental Health and Wellness

3 days ago

Dubai, Dubai, United Arab Emirates Health eCareers Full time
Job Summary

The Medical Director for Mental Health and Wellness is a key leader within the national program office responsible for ensuring high-quality mental health and wellness services are delivered to Kaiser Permanente members and patients. This role requires a strong clinical and medical expertise in mental health and wellness to identify areas of risk and care gaps, and to develop strategies to improve clinical outcomes. The Medical Director will provide medical and clinical expertise to create and maintain evidence-based practices, and will serve as a subject matter expert and advisor to legal counsel and the Kaiser Foundation Health Plan and Hospitals Board of Directors.

Key Responsibilities
  • Provide strategic, medical, and clinical expertise to Kaiser Permanente Behavioral and Mental Health teams to identify and resolve complex operational issues associated with access and quality of care.
  • Develop the California Mental Health and Wellness Quality Oversight program strategy in coordination with national, northern California, and southern California quality and mental health and wellness teams.
  • Understand global, national, and state trends and emerging methods that inform the development and deployment of performance reporting systems and oversight processes to surface relevant performance issues in a timely manner.
  • Perform medical case review for quality and risk evaluation and surface opportunities for improvement and considerations for peer review.
  • Develop, deploy, and manage a comprehensive system for monitoring and evaluating access and network adequacy, including policies and procedures for identifying and addressing problems with operational leaders.
  • Co-chair the Behavioral Health Quality Oversight Committees (BHQOC) and serve as a voting member on the KPNorthern California Quality Oversight Committee and the Southern California Quality Committee.
  • Provide input for the Mental Health and Wellness Joint Operational Northern California and Statewide committees.
  • In collaboration with Legal, Compliance, and regional leadership, provide leadership and promote compliance with all applicable legal and regulatory requirements related to the provision of mental health and wellness services.
  • Partner with Member Services and Experience leadership to surface and resolve issues related to member mental health services experience, complaints, and grievances and denials.
  • Provide consultation, guidance, and assure compliance with regulatory standards associated with the review of appeals, denials, and Independent Medical Review (IMR) and share lessons learned.
  • Contribute to regional policies, procedures, and practices for mental health and wellness policies. Develop and/or advise on new policies and procedures, as needed.
  • Partner with national colleagues on Non-Quantitative Treatment Limits (NQTL) comparative analyses.
  • Actively look to find synergies and best practices with colleagues in California and in other KP markets. Regularly perform external scans for best practices and benchmark performance.

Requirements

  • Strong clinical and medical expertise in mental health and wellness.
  • Experience in quality and risk management, and program development and implementation.
  • Excellent communication and leadership skills.
  • Ability to work collaboratively with cross-functional teams.
  • Strong analytical and problem-solving skills.
  • Ability to navigate complex regulatory requirements.

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