• UnitedHealth Group
  • $139,430.00 -171,530.00/year*
  • Fairbanks, AK
  • Healthcare - Physician
  • Full-Time
  • 650 Hollis St

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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 Senior Behavioral Medical Director to serve as the clinical team leader for behavioral managed care membership in the state of Alaska. 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 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 clinical 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
Responsible for 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 Alaska contract.
Required Qualifications: Doctor of Medicine or Osteopathy
Current license to practice as a physician without restrictions in the state of Alaska
Board certified by the American Board of Psychiatry and Neurology 2 years management experience overseeing multidisciplinary teams
Understanding of the Alaska Behavioral Health system of care, the services available, and the criteria for receiving services
Training required in Alaska Native Culture, historical trauma and the significance of the Adverse Childhood Experiences Survey scores for Alaskans
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 Preferred Qualifications: Minimum 5 years?? clinical experience post residency preferred
2 years managed care experience
Experience in managing BH Services including mental health and substance use disorders
Experience in public sector delivery systems and experience 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, Alaska
Associated topics: alumni, chief marketing officer, endowment, facebook, lead generation, newspaper, policies, presale, regulatory, social media

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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