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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Behavioral

Country:

United States

Postal Code:

02108

Approximate Salary:

Not Specified

Position Type:

Full Time

Behavioral Medical Director, Outpatient Speciality Programs (Telecommute)

UHG - Boston, Massachusetts

Posted: 09/13/2018

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)

 

The Behavioral Medical Director, Outpatient Specialty Programs 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 services
  • Responsible for Level of Care guidelines and utilization management protocols
  • Responsible for oversight and management with the Clinical Director and Clinical Program Director all utilization review, management and care coordination activities
  • Provide 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 preferences
  • Responsible 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 practitioners
  • Provide 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:

  • Doctor of Medicine or Osteopathy
  • Board Certified in Psychiatry
  • Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery
  • Experience working with community based programs and resources designed to aid the Medicaid population
  • Knowledge of post - acute care planning such as home care, discharge planning, case management, and disease management
  • PC proficiency, data analysis and strong organizational skills necessary

Preferred Qualifications:

  • Minimum of 3 years of experience as a practicing psychiatrist post residency
  • Board Certified in child & adolescent psychiatry 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)

 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

 

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.

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