Behavioral Medical Director Licensed and Residency in New Jersey - Remote

UnitedHealth Group•Newton, NJ

39d•$268,000 - $414,000•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. 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 and offer clinical, procedural, or administrative recommendations to psychiatrists and other behavioral health providers, medical physicians and nurses, clinical professionals, and/or state agencies who care for members, or consult on various processes and programs. The Medical Director is part of a leadership team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on health care system improvement opportunities. They are responsible for maintaining the clinical integrity of the program, including timely peer reviews, appeals and consultations with providers and other community-based clinicians, including general practitioners, and will work collaboratively with the Health Plan Medical Director, Clinical, Network and Quality staff. At Optum, our clinical vision drives the team to improve the quality of care our consumers receive. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Doctor of Medicine or Osteopathy
Current license to practice as a physician without restrictions in the state of New Jersey
Board certified in Psychiatry
Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management
Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery
Familiar with Substance Use Disorders, ASAM and treatment modalities including MAT (Medication Assisted Treatment)
Computer and typing proficiency, Microsoft Outlook and Teams, and data analysis
Currently reside in the state of New Jersey

Nice To Haves

3+ years of experience as a practicing psychiatrist post residency
Managed care experience
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

Responsibilities

Collaborate with the Utilization Management and Care Management teams to ensure delivery of cost-effective quality care that incorporates recovery, resiliency and person-centered services
Partner with the internal UM and CM teams, Health Plan, NJ state and the Providers
Responsible for Level of Care guidelines and utilization management protocols
Oversight and management, along with the Clinical Director and Clinical Program Director, utilization review, management and care coordination activities
Provide clinical oversight to the clinical staff, oversee the management of services at all levels of care in the benefit plan
Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience