Optum Behavioral Care is a newly formed business within United Health Group. Optum Behavioral Care seeks to deliver a high-value and efficient behavioral health system that can be scaled nationally, and the company will grow rapidly over the next 5 years.
The OBC behavioral health system will be built through strategic partnerships with innovative providers and service platforms, many that are new entrants and currently venture-backed. To evaluate partners and develop the care delivery system, in the first two years, OBC will launch pilot demonstrations in approximately 12 markets nationally. From these pilot demonstrations, OBC will build and scale the premier national behavioral health system for health systems, payers, state programs, and beyond.
The Optum Behavioral Care (OBC) Regional Medical Director will have accountability for the performance of all clinical operations and strategy for specific markets in which OBC delivers services. Optum Behavioral Care seeks to build a high-value and efficient behavioral health system that can be scaled nationally. This system will be built through strategic partnerships with existing behavioral health providers and service platforms. In the first two years, the company will launch approximately 12 national pilot evaluations of potential partners to build the high value behavioral health system. From those pilot evaluations, long-term partners will be identified to build the ongoing premier behavioral health system.
The Optum Behavioral Care Regional Medical Director is responsible for building and executing the clinical strategy in specific markets, in partnership with the Optum Behavioral Care Chief Medical Officer and the General Manager(s) for specific markets. He/she (they) will analyze strengths and gaps in the local network and identify regional and national providers to bring together and form the high value behavioral health system. They will work closely with clinical leaders in each market to build clinical policies, workflows, referral, and care transition plans to ensure that members receive timely, coordinated and high-quality care. They will work to proactively identify individuals in need of care and help match with appropriate clinical resources to maximize health outcomes. If issues arise, the Regional Medical Director will intervene to ensure that members are connected with appropriate treatment and resources. They are responsible for all clinical and health outcomes of the regional behavioral health system. When indicated, they will conduct rapid-cycle quality improvement interventions to ensure the delivery of high-value care.
The Regional Medical Director must have a strong background in behavioral health care delivery and be able to work across treatment settings to build a coordinated, effective system of care. They must have exceptional communication skills and ability to build alliances, as they will work with clinical providers of all backgrounds to align priorities and maximize health outcomes. Experience with integrated care, behavioral health outcome measurement is essential. This person needs to be very organized and detail oriented.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges
- Build and execute the clinical policies and strategy within regional markets.
- Bring together stakeholders across multiple clinical settings and levels of care to deliver efficient and well-coordinated behavioral health treatment.
- Intervene as indicated to ensure that patients receive timely, high quality, and coordinated care.
- Conduct analyses, review reports, and track any trends related to health care quality, cost and other key clinical processes
- Deliver rapid-cycle quality improvement interventions as indicated.
- Collaborate with product organization and functional partners to continually seek ways to enhance and quantify the value of existing services and develop new products and solutions to address emerging market opportunities
- Work in partnership with operational teams to address variation in quality and affordability using the most efficient and effective process, and to avoid overlapping or redundant approaches
- Support the execution of academic partnerships, publications, presentations and other activities that positions Optum and UHC as the clinical thought leader in areas of strategic importance
- Support the business in identifying market trends that should influence key investments (i.e., technology investments and/or M&A)
- Represent OBC as point of contact for state and national professional societies / trade associations and through speaking opportunities at local and national conferences
- Collaborate with all internal partners to socialize consumer and provider Net Promoter Scores (NPS) data and drive actions that create a better consumer and provider experience and improvement in our NPS
- In partnership with other provider experience Optum partners, help develop provider and patient segmentation models that determine the best mode of provider interaction/engagement and ease of experience
- Enhance programs that build trust within the provider community and encourage providers to partner with OBH on clinical initiatives that drive improved consumer outcomes and reduced costs of care
- Improve the ability of our programs to deliver actionable, real-time data into the hands of our providers
- Focus on improving the service system through enhancements to network services, provider engagement and consumer experience
- Create and maintain strong relationships with key clinical leaders across Optum and UHG
- Discuss case information with internal or external parties (e.g., case managers, other medical directors, clinical providers, physicians)
- Provide feedback to team members and other departments to refine decision making and promote a shared understanding of benefit or coverage decisions
- Assess and interpret complex financial and clinical data to evaluate feasibility of proposed initiatives
- Identify and implement development resources in response to business needs and regulatory changes
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.
- Doctor of Medicine (MD or DO) degree; with unrestricted medical license
- Board certified in Psychiatry
- Minimum of 5 years clinical practice experience
- 3+ years in care delivery practice facilitation and system transformation
- 3+ years of experience leading and implementing clinical programs; ranging from large systems, acute care facilities, outpatient practices, innovative startups, etc.
- Experience and comfort working with and driving results from clinical leadership of diverse and heterogenous clinical entities
- Experience in managed care industry with strong knowledge of managing behavioral benefit risk and experiencing managing care across the continuum of care including acute and chronic condition management, utilization management and preventative services essential. Understanding of managing physical health benefit risk a plus.
- Knowledge and experience addressing issues of health disparities and equity in the delivery of health services experience is essential
- Familiarity with commercial, government and provider markets and experience setting clinical policy for wellness, case management, disease management and specialized networks
- Demonstrated knowledge and accomplishments in the areas of behavioral care delivery systems, utilization management, case management, disease management, quality improvement, product development and peer review
- Proficiency in leveraging data and trend to make business decisions and willingness to expand knowledge and ability to apply data to improve care
- Experience in client-facing customer relationship management
- Experience in population health management
- Past success working collaboratively in a highly-matrixed environment to deliver results
- Ability to navigate ambiguity and seek appropriate resources/tools
- Self-motivated and able to work with little direct supervision and drive results with disciplined follow-though
- Strong strategic thinking and business acumen with the ability to align clinical related strategies and recommendations with business objectives
- Proven ability to quickly gain credibility, influence and partner with staff, business leaders and the clinical community
- Strong belief in evidence-based medicine and familiarity with current behavioral issues and practices, and willingness to teach teams to facilitate most up-to-date evidence-based care delivery
- Proven ability to develop relationships with network and community providers
- Willingness to travel as determined by business need
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders.
- MBA, MHA or experience in health care management consulting in provider or payer side
- Prior experience in leading and developing matrixed teams. Experience leading teams for rapid ideation, implementation of new innovations, and for quality improvement exercises
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
Colorado Residents Only: The salary/hourly range for Colorado residents is $130,300 to $250,200 (add additional reference for sales and physicians). Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Behavioral Care, Regional Director, Telecommute, Clinical Strategy, Administration, Managed Care