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Associate Behavioral Medical Director - Boston, MA

UnitedHealth Group


Location:
Wellesley, MA
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1755324
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Job Details


Associate Behavioral Medical Director - Boston, MA(Job Number:717882)
Description

OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.  OptumHealth is a leading provider of emotional wellness services.  With us you can improve the health of others and help heal the health care system. You can work with an incredible team culture; a clinical and business collaboration that is learning and evolving every day.  When you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
 
This full-time position is responsible for a significant amount of direct facing customer contact with our client, Harvard Pilgrim, and whose regular presence will be required at major providers in the Boston area to include working on-site at the client offices. The Associate Medical Director will also be responsible for providing oversight and direction of the Utilization Management Program and performing peer reviews as necessary.  They are involved in the development and implementation of medical expense initiatives, advising leadership on improvement opportunities regarding medical expense programs as well as clinical activities.
 
Primary Responsibilities:
  • Serve as primary dedicated MD/clinical contact for Harvard Pilgrim Health Care account
  • Develop and participate in clinical and quality management processes and implementation of UBH's clinical policies
  • Develop coordination of care rounds with HPHC’s care management staff and chair weekly meetings
  • Assist with article writing for the client’s member and provider communications
  • Contribute to Optum’s content for HPHC’s client presentations
  • Participate in the development of clinical programs and have an impact on population heath management
  • Work closely with managers and senior level staff internally and externally
  • Oversee reviews in support of Optum case management activities including inpatient hospitalization and other acute care services
  • Keep current with respect to treatment policies, guidelines and philosophies
  • Support the activities of the Provider Service staff in the development and maintenance of an adequate provider network, including involvement in credentialing, quality improvement activities and network development activities
  • Available for peer to peer review consultation with network and non-network providers
  • Represent OptumHealth through regular participation on client meetings, committees, associations, etc
  • Conduct reviews and make determinations on appeals

Job Behavioral Clinical Consulting
Primary Location US-MA-Wellesley
Other Location US-MA-Boston
Organization Optum Ops-PHM Utilization Mgmt
Schedule Full-time
Number of Openings 1
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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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