Optum
The Behavioral Medical Director provides oversight and direction of the Utilization Management Program, performs peer reviews, and collaborates with clinical and health plan leadership to maintain clinical integrity and improve health care system quality. Responsibilities include managing utilization review, care coordination, and ensuring evidence-based, person-centered care practices. The role requires a licensed, board-certified psychiatrist and involves leadership within a remote work setting.
Company Overview
Industry: Healthcare Technology
Company Size: 500-1,000 employees
Founded: 2015
Headquarters: San Francisco, CA
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Key Contacts
Contact information not available
About the Company
Leading healthcare technology company focused on improving patient outcomes through innovative digital solutions. We're transforming the way healthcare is delivered with cutting-edge technology and data-driven insights. Our platform serves over 10,000 healthcare professionals and has processed millions of patient interactions.
Recent News & Updates
The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management Program and performing peer reviews as necessary. This individual will interact directly with Psychiatrists, Behavioral Health Providers, and other clinical professionals who consult on various processes and programs. The Behavioral Medical Director is part of a leadership team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on health care system improvement opportunities. They are responsible for maintaining the clinical integrity of the program, including timely peer reviews, appeals and consultations with providers and other community based clinicians, including general practitioners, and will work collaboratively with the Health Plan Medical Director, Clinical, Network and Quality staff. At Optum, our clinical vision drives the team to improve the quality of care our consumers receive.
You’ll enjoy the flexibility to work remotely * from anywhere within the Eastern Time Zone as you take on some tough challenges.
Primary Responsibilities
- Ensuring delivery of cost effective quality care that incorporates recovery, resiliency and person-centered services
- Level of Care guidelines and utilization management protocols
- Oversight and management, along with the Clinical Director and Clinical Program Director, utilization review, management and care coordination activities
- Provide clinical oversight to the clinical staff, oversee the management of services at all levels of care in the benefit plan
- Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience
Required Qualifications
- Doctor of Medicine or Osteopathy
- Current license to practice as a physician without restrictions
- Board certified in Psychiatry
- Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management
- Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery
- Computer and typing proficiency, data analysis and strong organizational skills
- Participate in rotational holiday and call coverage
- Board certification in Child and Adolescent Psychiatry or Addiction Medicine
- 3+ years of experience as a practicing psychiatrist post residency
- Managed care experience
- Experience in public sector delivery systems and experience in state specific public sector services
- Experience working with community based programs and resources designed to aid the State Medicaid population
- Based in Eastern Time zone
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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