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in Honolulu, HI

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Hours Full-time, Part-time
Location Honolulu, HI
Honolulu, Hawaii

About this job

No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. You'll help improve the health of millions. And you'll do your life's best work.(sm)


Responsible for the medical oversight of the clinical activities. This includes development and implementation of medical consultation and supervision policies and services, quality assurance activities, the medical supervision of clinical staff, and collaboration with other Clinical Operations staff to oversee all clinical policies, procedures, and programs.

 


  • Provides clinical leadership for healthcare affordability initiatives.

  • Conducts concurrent and retrospective clinical reviews, peer to peer reviews, and clinical case staffings in support of OHBS' utilization management activities.

  • Supports the activities of the Behavioral Network Services staff in the development and maintenance of an adequate provider network, including involvement in quality improvement activities, and network development activities.

  • Supports the activities in the development and implementation of new services.

  • Supports and participates in customer audits and presentations

  • Serves as the designated senior behavioral healthcare practitioner advising aspects of the QI Program related to clinical care and safety, is accountable for providing leadership for, and is actively involved in the implementation of the QI Program.

  • Oversees and participates in Health Plan accrediation activities and state regulatory activities.

  • Effectively engages and brings understanding to our external constituents such as physicians, medical and specialty societies, hospitals and hospital associations, and state regulators

  • Promotes preventive behavioral health strategies

  • Is involved in committees as assigned by the Regional Vice President

 

Requirements


  • Licensed  Board Certified Psychiatrist required; HI license required

  •                 Knowledge and understanding of Hawaii's overall behavioral health system.

  •                 Experience in public sector delivery systems and experience in Hawaii public sector services preferred.

  •                 Minimum of eight years of experience as a practicing psychiatrist

  •                 One year plus experience in managed care conducting Utilization Management activities preferred

  •                 Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery

  •                 Demonstrated commitment to assisting people to maintain in the community with maximum independence and self-sufficiency and understanding of the appropriate use of wraparound, in home stabilization services and natural community supports to maximize community tenure.

  •                 Demonstrated ability to lead and teach others

  •                 Excellent communication, negotiation and customer service skills required

  •                 Experience working with community based programs and resources designed to aid the Hawaii Medicaid population.

  •                 Minimal local travel required.

  •                 PC proficiency, data analysis and strong organizational skills necessary

 



 


 


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




Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.




UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.