UnitedHealth Group Senior Behavioral Medical Director Salt Lake City Utah in Kearns, Utah
At Optum, our mission is to make the health system work better for all. The Senior Behavioral Medical Director serves as the clinical team leader for a large behavioral managed care membership in the state of Utah. They are accountable for the strategic approach to executing our annual business objectives in alignment with the larger organization. They work collaboratively with other functional partners such as Care Advocacy, Quality Improvement, State and Legal Compliance, providing medical subject matter expertise. The SMD is also actively involved in the implementation, supervision, oversight and evaluation of the Utilization Management program, develops and implements Utilization Management policies and procedures, monitors the consistency with which Utilization Management criteria are applied; through supervision, case review, training and consultations with Peer Reviewers, making coverage decisions and participates in committee meetings. Additionally, the Senior Medical Director serves as the liaison with network providers and the medical delivery system.
Serve as the lead physician for the Behavioral Health plan working closely with medical management team leaders
Develops programs to promote integration of physical and behavioral health services which support continuity and coordination among all network providers
Overall responsibility for implementation of the Utilization Management program
Monitors behavioral healthcare utilization authorization and claims data for all healthcare services
Assures that policies adhere to contractual obligations
Develop targeted education and training for and provide clinical guidance to the Care Advocates
Leadership and oversight of contract adherence as well as Profit & Loss management
Performs Clinical Case reviews in conjunction with Clinical and Quality departments
Consultation with practitioners in the Optum clinical network
Participation in clinical workgroups as required
Chairing Utilization Management Committee and participation in additional committees as required
Collaborates in network provider initiatives and engagement
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Doctor of Medicine or Osteopathy
Current license to practice as a physician without restrictions in the state of Utah; or willing to obtain
Board certified in Psychiatry
Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery
Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management
Computer and typing proficiency, data analysis and strong organizational skills
Minimal local travel required
2 years managed care experience
2 years management experience overseeing multidisciplinary teams strongly preferred
5 years of experience as a practicing psychiatrist post residency strongly preferred
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
At Optum, our mission is to improve health care for all. The Senior Behavioral Medical Director serves as the Behavioral CMO for a large State-specific managed care organization. They provide clinical leadership and oversight to a multidisciplinary team, work collaboratively to develop and implement clinical policy, and align strategic goals with business objectives. The CMO is a member of the health plan leadership team and collaborates to oversee case advocacy, quality improvement , regulatory compliance, and utilization management. They will provide leadership to State-wide initiatives for behavioral-medical intervention as well as MAT. The CMO has the opportunity to be at the leading edge of implementation of population health strategies.
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: Behavioral Medical Director, Doctor of Medicine or Osteopathy, Psychiatry, Salt Lake City, Utah, UT