Optum Behavioral operates as one of the nation’s leading managed behavioral care organizations. With more than 130,000 clinicians and facilities, our tiered behavioral health network is one of the largest in the United States. Our clinical bench of more than 1,000 doctors and other clinicians — many of them specialists in behavioral health conditions — focus on what matters most.
The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management Program and performing peer reviews as necessary. 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 Director will also advise leadership on improvement opportunities regarding medical expense programs and clinical activities that impact medical expense. Our clinical vision drives the team to improve the quality of care our consumers receive.
- 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
To be considered for this position, applicants need to meet the qualifications listed in this posting.
- Licensed Physician in the state of Nebraska required
- Board Certified in Psychiatry required, sub specialty in child & adolescent or addictions preferred
- Minimum of 3 years of experience as a practicing psychiatrist post residency strongly preferred
- 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 Iowa Medicaid population
- Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management
- Minimal local travel required
- PC proficiency, data analysis and strong organizational skills necessary
- Experience in public sector delivery systems and experience in Nebraska 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)
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.
Sorry,this is NOT an opportunity for Search Firm recruiters.