No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. You'll help improve the health of millions. And you'll do your life's best work.(sm)
At Optum, our mission is to make the health system work better for all. We are currently looking for a Behavioral Medical Director to serve as the clinical team leader for behavioral managed care membership in the state of Maryland. The successful candidate will be accountable for the strategic approach to executing our annual business objectives in alignment with the larger organization. They will work collaboratively with other functional partners such as Care Advocacy, Quality Improvement, State and Legal Compliance, providing medical subject matter expertise. The MD 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 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
Develop 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
Monitor behavioral healthcare utilization authorization and claims data for all healthcare services
Assure that policies adhere to contractual obligations
Develop targeted education and training for and provide clinical guidance to the Care Advocates
Direct supervision and mentorship to clinical team
Perform Clinical Case reviews in conjunction with Clinical and Quality departments
Consultation with practitioners in the Optum clinical network
Participation in clinical work groups as required
Participation in committees as required
Collaborate in network provider initiatives and engagement
Oversight of clinical decision-making
Facilitate coordination of core business functions across business units; Oversee the clinical administrative operations of the program to ensure appropriate services are provided under the Maryland contract
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 Maryland; or willing to obtain
Board certified by the American Board of Psychiatry and Neurology
Understanding of the Maryland Behavioral Health system of care, the services available, and the criteria for receiving services
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
Minimal local travel required depending on location
Computer and typing proficiency, data analysis and strong organizational skills
3 years of clinical experience post residency
2 years of managed care experience
Experience in managing BH Services including mental health and substance use disorders
Experience in public sector delivery systems and in state specific public sector service
Experience working with community based programs and resources designed to aid the State Medicaid population
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.
Job Keywords: Clinical, Psychiatrist, Mental Health, Behavioral, Maryland, MD
Unitedhealth Group Inc.