For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) Optum Behavioral operates as one of the nation's leading managed behavioral care organizations. With more than 130,000 clinicians and facilities, our tiered behavioral health network is one of the largest in the United States. Our clinical bench of more than 1,000 doctors and other clinicians - many of them specialists in behavioral health conditions - focus on what matters most. The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management Program and performing peer reviews as necessary. Peer review activities include outpatient management, IOP, CCR and retrospective review, as well as public sector services such as psychosocial rehabilitation, case management and habilitative treatment activities for members with severe and persistent mental illness. This individual will interact directly with Psychiatrists, Prescribers, and other clinical professionals who consult on various processes and programs. It will include roles which manage development and implementation of medical expense initiatives. The Medical Director will also advise leadership on improvement opportunities regarding medical expense programs and clinical activities that impact medical expense. Clinical vision drives the team to improve the quality of care our consumers receive. Primary Responsibilities:Ensuring delivery of cost effective quality care that incorporates recovery, resiliency and person-centered servicesResponsible for Level of Care guidelines and utilization management protocolsResponsible for oversight and management with the Clinical Director and Clinical Program Director all utilization review, management and care coordination activitiesProvide clinical oversight to the clinical staff, oversee the provision of both inpatient and outpatient services; and keep current regarding prevalent treatment protocols and philosophies including those that address consumer cultural preferencesResponsible for maintaining the clinical integrity of the program, including concurrent reviews of outpatient services; providing oversight to utilization management and quality staff; providing consultation to providers and other community based clinicians, including general practitionersProvide timely psychiatric services for the behavioral health operation including communication with the Health Plan Medical Director, clinical and quality staff, medical necessity review and recommendations, service denial reviews, grievance issues, medication reviews, and clinical best practices guideline development
Required Qualifications:Licensed Physician requiredDemonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recoveryExperience working with community based programs and resources designed to aid the Medicaid populationKnowledge of post - acute care planning such as home care, discharge planning, case management, and disease managementMinimal local travel requiredPC proficiency, data analysis and strong organizational skills necessaryPreferred Qualifications:Minimum of 3 years of experience as a practicing psychiatrist post residency Board Certified in Psychiatry required, sub specialty in child & adolescent or addiction Experience in public sector delivery systems and experience in public sector services Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: Psychiatrist, Medical Director, Telecommute, Work From Home, Utilization, Peer Reviews, Managed Care
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.