Spectrum Healthcare Resources is excited to offer a potential career opportunity for a Behavioral HealthMedical Director supporting the TriCare/Department of Defense and Community Care Network/Department of Veterans Affairs. This remote-based civilian position is an outstanding chance to make a meaningful contribution to the healthcare of veterans and military beneficiaries while benefiting from work-life flexibility, professional collaboration, and impactful leadership. Join us in leading high-quality care initiatives for those who have served our country, with a focus on system-wide clinical improvement, peer collaboration, and mission-driven support! Requirements: - Doctor of Medicine (MD) or Doctor of Osteopathy (DO) from an accredited medical school. - Active, unrestricted license to practice medicine in the United States. - Board certification or board eligibility through a recognized specialty board. - U.S. Citizenship. - Favorable background investigation through the Department of Defense (DoD). - Minimum of 5 years of medical practice experience. - 3+ years of experience in managed care environments. - Preferred: - Experience working with TRICARE, Veterans Affairs, or other federal health plans. - Advanced degree in management (MPA, MBA, MHA, MPH). - Corporate-level leadership experience. - Experience using InterQual and/or similar evidence-based criterial to assess medical interventions, procedures and treatments. Job Responsibilities: - Provide program-wide clinical guidance across multiple medical management domains including Utilization Management, Case Management, Quality, and Public Health. - Lead and participate in quality committees and collaborative safety initiatives. - Review member cases for appropriateness and quality of care; document findings in CareRadius and other health systems. - Conduct peer-to-peer discussions with network providers and internal stakeholders. - Develop and implement corrective action plans related to clinical quality or provider performance. - Collaborate closely with TriWest teams such as Clinical Operations, Data Analytics, and General Counsel. - Provide clinical expertise on new technologies, treatment protocols, and population health initiatives. - Interact with veterans and beneficiaries to support satisfaction and outcomes. - Stay current with required licensure, board certification, and federal medical standards. Working Conditions: - Remote position with standard weekday hours and occasional after-hours availability. - Extensive computer-based work; prolonged periods of sitting may be necessary. Company Overview: Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Militaryand VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinicsand other Federal Agencies through various contracting veh
