Remote Part‑Time Medical Director of Behavioral Health – Clinical Leadership, Utilization Management & Quality Improvement for California Health Plans

About the Opportunity

Imagine shaping the future of behavioral health care for millions of members across Medicaid, Medicare, and commercial plans—all from the comfort of your home. Workwarp is partnering with a leading national health‑care organization to bring on a visionary Medical Director of Behavioral Health who will drive clinical excellence, ensure cost‑effective care, and champion quality improvement initiatives. This remote, California‑based position offers the flexibility of part‑time work while providing the influence and responsibility of a senior clinical leader.

As a Medical Director, you will be the clinical compass for interdisciplinary teams, overseeing complex cases, guiding utilization management (UM) strategies, and translating evidence‑based policies into real‑world outcomes. You will collaborate directly with psychiatrists, primary care physicians, and specialty providers to guarantee that individuals with severe, treatment‑resistant mental health conditions receive coordinated, medically necessary care throughout every phase of treatment—from inpatient admission to community‑based outpatient services.

Key Responsibilities

• Clinical Leadership & Oversight: Provide day‑to‑day physician guidance to interdisciplinary UM teams, actively participate in case management of high‑risk patients, and make informed medical necessity decisions across the continuum of care.
• Utilization Management Program Development: Design, implement, and continuously evaluate a robust UM action plan that balances high‑quality patient outcomes with cost‑effective service delivery. Monitor for over‑ and under‑utilization, adjust criteria, and educate staff on best practices.
• Policy & Procedure Implementation: Work with corporate clinical teams to operationalize Magellan’s clinical practice standards, develop medical policies, and interpret technology assessments and medical necessity guidelines.
• Stakeholder Collaboration: Build and nurture relationships with external providers, treatment programs, and client organizations. Conduct peer‑review sessions with psychiatrists and other specialists, offering educational interventions and quality‑of‑care feedback.
• Regulatory & Accreditation Compliance: Ensure adherence to NCQA, URAC, state, and federal policies for each client. Lead continuous quality improvement (CQI) initiatives, prepare for certification audits, and maintain compliance documentation.
• Appeals & Incident Investigation: Oversee the integrity of internal and external appeals processes, investigate adverse incidents, and drive corrective actions to improve patient safety and satisfaction.
• Leadership Support: Assist senior medical directors with medical action plan development, parity analyses, and documentation. Participate in Joint Operations Committee (JOC) and other cross‑functional committees.
• After‑Hours Coverage: Provide on‑call support as needed to meet health‑plan deliverables and ensure continuity of care for urgent cases.
• Professional Development & Mentorship: Mentor junior clinicians, share expertise in cost‑benefit analysis, credentialing, and quality assurance, and stay current with emerging behavioral health trends.

Essential Qualifications

• Medical Licensure: Unrestricted, active California medical license (MD, DO, or internationally‑trained MBBS with successful US residency and ECFMG/FLEX certification).
• Board Certification: Current board certification in Psychiatry, Psychiatric Sub‑Specialties, Primary Care, Geriatrics, Palliative Care, or Physical Medicine.
• Education & Training: MD, DO, or MBBS degree with completion of a U.S. or Canadian ACGME‑accredited residency. Minimum three years of direct patient care experience across multiple levels of care (inpatient, outpatient, partial hospitalization, etc.).
• Clinical Expertise: Demonstrated experience managing complex, severe, or treatment‑resistant mental health conditions and familiarity with the full spectrum of behavioral health services.
• Leadership Ability: Proven track record of leading interdisciplinary teams, influencing practice standards, and driving quality improvement initiatives.
• Communication Skills: Exceptional oral and written communication to convey clinical guidance, influence stakeholder decisions, and produce clear documentation for regulatory bodies.

Preferred Qualifications & Desirables

• Experience with utilization management, cost‑benefit analysis, and medical decision‑making frameworks.
• Background in developing or overseeing NCQA‑compliant quality improvement activities.
• Familiarity with URAC standards, state Medicaid/Medicare regulations, and health‑plan contract requirements.
• Experience in tele‑health delivery models and remote clinical supervision.
• Proven ability to work flexible hours, including after‑hours coverage, to meet plan deliverables.
• Prior involvement in appeals processes, incident investigations, or accreditation preparation.

Core Skills & Competencies

• Clinical Judgment: Ability to assess complex cases, determine medical necessity, and prioritize interventions that balance efficacy and cost.
• Analytical Thinking: Skilled in interpreting utilization data, identifying trends, and translating findings into actionable policies.
• Strategic Vision: Capacity to align clinical initiatives with broader organizational goals and health‑plan objectives.
• Collaboration & Influence: Strong interpersonal skills to build rapport with providers, payer representatives, and internal teams.
• Regulatory Acumen: Knowledge of NCQA, URAC, HIPAA, and state/federal regulations governing behavioral health services.
• Technology Proficiency: Comfortable with electronic health record (EHR) systems, utilization management platforms, and data analytics tools.
• Education & Mentorship: Passion for teaching, coaching, and developing the next generation of behavioral health clinicians.

Career Growth & Learning Opportunities

Joining this remote leadership role opens doors to a vibrant network of national health‑care experts and offers a clear pathway for professional advancement. You will have access to:

• Continuous medical education (CME) programs and specialty conferences funded by the organization.
• Mentorship from senior medical directors and executives focused on strategic leadership development.
• Opportunities to spearhead innovative projects such as integrated care models, digital therapeutics, and value‑based payment initiatives.
• Potential transition to full‑time or expanded regional leadership roles based on performance and organizational needs.

Work Environment & Culture

Workwarp values flexibility, inclusivity, and a collaborative spirit. Although the role is remote, you will be part of a supportive, high‑performing clinical community that emphasizes:

• Transparent communication and regular virtual team huddles.
• Work‑life balance with a part‑time schedule that respects personal commitments.
• Diverse perspectives, fostering an environment where every clinician feels heard and valued.
• Commitment to equity, diversity, and inclusion (EDI) across all operations and patient populations.

Compensation, Perks & Benefits

The position offers a competitive salary range of $200,280 – $360,500, reflective of experience, expertise, and geographic considerations. In addition to base pay, eligible candidates may receive:

• Short‑term incentive bonuses tied to performance metrics and quality outcomes.
• A comprehensive benefits package covering health, dental, vision, life, and disability insurance.
• Retirement savings options with employer matching contributions.
• Paid time off, parental leave, and flexible scheduling to support personal well‑being.
• Professional development reimbursements, CME allowances, and access to advanced clinical resources.
• Employee assistance programs (EAP) focusing on mental, emotional, and financial health.

Why This Role Is a Game‑Changer

Behavioral health is at a critical inflection point, and leaders who can blend clinical expertise with data‑driven utilization management are in high demand. As the Medical Director, you will directly influence how thousands of Californians receive compassionate, high‑quality mental health care—making a tangible impact on patient outcomes, cost efficiencies, and the overall health‑care ecosystem.

Take the Next Step

If you are a board‑certified physician with a passion for driving systemic improvement, an aptitude for leading interdisciplinary teams, and the desire to work remotely while shaping policy for a major health‑plan network, we want to hear from you. This is more than a job; it’s a chance to leave a lasting legacy in behavioral health.

Apply Today

Seize this opportunity to advance your career, influence clinical practice at scale, and improve the lives of countless individuals. Click the link below to submit your application and join a forward‑thinking organization dedicated to excellence in behavioral health.