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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:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Senior Behavioral Medical Director (Psychiatrist) - TN

UHG - Franklin, Tennessee

Posted: 12/12/2018

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. The Senior Behavioral Medical Director serves as the clinical team leader for a large behavioral managed care membership. 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.

 

Primary Responsibilities:

  • 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

  • Direct Supervision and mentorship to Psychiatry team

  • 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

  • Participation in committees as required

  • Collaborates in network provider initiatives and engagement


Required Qualifications:

  • Doctor of Medicine or Osteopathy
  • Current license to practice as a physician without restrictions in the state of TN
  • Board certified in Psychiatry
  • 2 years management experience overseeing multidisciplinary teams
  • 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
  • Computer and typing proficiency, data analysis and strong organizational skills

 

Preferred Qualifications:

  • 2 years managed care experience
  • 5 years of experience as a practicing psychiatrist post residency
  • Board certified in Addiction Psychiatry
  • 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

 

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.

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