Clinical Director

Description

About BPA Health

At BPA Health, we believe that how we accomplish our work is just as important as what we accomplish. Our culture is grounded in four Core Values: Growth Mindset, Actively Engage, Do the Right Thing, and Do What You Say. These values shape the way we lead, collaborate, solve problems, and serve our clients, providers, and the individuals who rely on us every day.

BPA Health operates on the Entrepreneurial Operating System® (EOS®), creating clarity, accountability, and alignment throughout the organization. Leaders thrive by embracing ownership of their outcomes, working collaboratively across teams, addressing issues at their root cause, and continually improving the way we serve. Success is measured not only by results, but by achieving those results in a way that reflects our Vision, Core Values, and commitment to exceptional care and service.

Position Summary

The Clinical Director serves as the organization's senior behavioral health clinical leader and provides strategic clinical governance across the organization. The position provides leadership for clinical quality, provider credentialing oversight, behavioral health utilization management consultation, evidence-based practice, clinical risk management, quality improvement, and innovation. This is a strategic leadership role rather than a direct patient-care role and collaborates with the Medical Director, executive leadership, Quality Management, Credentialing, Utilization Management, and Network Management to maintain compliance with NCQA standards, contractual obligations, and applicable regulations.

Clinical Standards & Quality

• Establish behavioral health clinical standards.

• Approve clinical policies within delegated authority.

• Promote evidence-based practices.

• Support Quality Management.

Provider Credentialing Oversight

• Provide clinical oversight of behavioral health credentialing.

• Chair the Credentialing Committee.

• Review credentialing exceptions requiring clinical judgment.

• Collaborate with the Medical Director on physician credentialing and complex cases.

Utilization Management

• Provide behavioral health consultation for UM.

• Review behavioral health criteria.

• Monitor consistency of behavioral health decisions.

• Support appeals analysis and improvement.

Clinical Risk & Quality

• Review significant incidents.

• Participate in Quality and FWA activities.

• Recommend corrective actions.

• Escalate significant risks.

Clinical Innovation & Outcomes

• Evaluate emerging practices.

• Recommend new clinical models.

• Review outcomes and benchmarks.

• Support strategic planning.

Clinical Consultation & Representation

• Serve as senior behavioral health advisor.

• Consult on complex provider and operational issues.

• Represent the organization during external surveys, reviews and presentation.

Organizational Authority

• Approve behavioral health clinical policies within delegated authority.

• Recommend credentialing actions for behavioral health practitioners.

• Require review of clinical quality concerns.

• Escalate significant clinical risks to executive leadership.

• Serve on or chair designated clinical committees.

Relationship to Medical Director

The Clinical Director provides behavioral health clinical leadership and organizational clinical governance. Responsibilities requiring physician judgment remain the responsibility of the Medical Director or another appropriately qualified physician. The Clinical Director collaborates with the Medical Director on credentialing, utilization management, quality management, and clinical policy.

Requirements

Qualifications

• Doctoral degree in an appropriate behavioral health discipline.

• Current unrestricted professional license in Idaho.

• Behavioral health leadership experience.

• Knowledge of NCQA, credentialing, utilization management, quality management, and ASAM Criteria.

• Managed behavioral health, EAP, SUD, or ASO experience preferred.