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, and 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

• Serves 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
• Develops targeted education and training for and provides 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

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Doctor of Medicine or Osteopathy
• Current license to practice as a physician without restrictions in the state of Oregon
• Board certified in Psychiatry
• 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, with data analysis and strong organizational skills

Preferred Qualifications:

• 2+ years of managed care experience
• 5+ years of experience as a practicing psychiatrist post residency
• Experience in public sector delivery systems and 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)