Behavioral Medical Director Alaska

UnitedHealth Group   •  

Anchorage, AK

Industry: Healthcare


Less than 5 years

Posted 37 days ago

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 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 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.�

Primary Responsibilities:

  • 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 workgroups 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 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
  • 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 experience,�and strong organizational skills

Preferred Qualifications:

  • 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