Minneapolis, MN, Atlanta, GA, Las Vegas, NV, Albuquerque, NM, Houston, TX Candidates need to be able to work in the City or State specified – Telecommute
Title: Medical Director – Behavioral Health
Location: Minneapolis Minnesota United States
Contest Number: 818697
Family: Medical and Clinical Operations
Function: Clinical Analysis & Consulting
Region: North America
Country: United States
Other States: Georgia Nevada New Mexico Texas
Other Cities: Atlanta Las Vegas Albuquerque Houston
Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 6 industry leader.
The CQM Medical Director is responsible for physician oversight and peer review (PR) activities related to PQI, patient safety initiatives, and clinical quality improvement activities.
Duties To Include:
Recruit and assemble practicing community physicians for the Peer Review Committee
Prepare for Peer Review Committee meetings
Chair the committee meetings
Determine level of PQI and if IRO necessary by complexity and/or severity level
Ensure timely turnaround times to meet contract requirements
Determine CAP if needed and track provider
Work with CQM team on CQM studies, quality improvement initiatives, and quality improvement projects
Assist in developing reports to National Credentials Center and/or Network (United Health Network, UHN and United Behavioral Health Network, UBH) and licensing boards when necessary
Licensed physician; Board Certified in an ABMS or AOBMS, Psychiatry.
5+ years clinical practice experience; strong knowledge of managed care industry.
2 ? 3 years quality management experience.
Familiarity with current medical issues and practices.
Excellent interpersonal communication skills.
Superior presentation skills for both clinical and non-clinical audiences.
Proven ability to develop relationships with other VACCN divisions, network physicians, Independent Review Organizations (IRO), community physicians on committee, other network providers, and with government providers and representatives
Excellent project management skills.
Solid data analysis and interpretation skills; ability to focus on key metrics.
Strong team player and team building skills.
Strategic thinking with proven ability to communicate a vision and drive results.
Solid negotiation and conflict management skills.
Creative problem solving skills.
Proficiency with Microsoft Office applications.
Ability to work with Clinical Quality Management team for data entry of providers and tracking and trending, chart retrieval, minutes, CQM studies, quality improvement initiatives, and quality improvement projects and other support functions.
Ability to work with Legal Office
Transforming health care and millions of lives starts with the values you embrace and the passion you bring. Find out more and join us. It’s an opportunity to do your life’s best work.SM
OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
Medical & Health , Doctor & Practitioner , Operations , Project Management