MD Behavioral Health Psychiatry

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role This position is accountable for providing day-to-day guidance, support and medical leadership for utilization management activities and decisions within the Behavioral Health function. This position is responsible for supporting the Medical Director-Behavioral Health in all aspects of utilization management. Analyzes data from a variety of sources to identify trends and or issues. Participates on various internal or external committees as assigned. What You'll Do Responsibilities: Provides medical expertise based on extensive knowledge of health care delivery systems, utilization and reimbursement methods, and treatment protocols for the Behavioral Health function.​ Supports, guides and consults with BH Clinician reviewers on pre-authorization, concurrent and retrospective review issues or decisions. Supports, guides an