Medical Director, Sr. Psychiatrist, Utilization Management
1 month ago
This is a newly formed unit that will operate under the direction of the Director of BHS Managed Care and the UM Unit Manager. The desired candidate will provide clinical leadership, guidance and support for the team and work in partnership with the UM Unit Manager as Co- Chair of the UM Committee. This position is currently .6 FTE. As the unit grows and efficiency improves, we anticipate that the UM Medical Director could increase to 1.0 FTE.
The Utilization Management (UM) Medical Director serves as the designated physician who is involved in SFDPH BHS UM program development, evaluation, and provides clinical oversight of UM activities and consultation to UM Clinical Reviewers as needed. BHS UM Medical Director reviews data and reports with the UM Unit Manager for needed action and makes recommendations based on evidence-based clinical care and promising practices. The BHS UM Medical Director is available for assistance with member behavioral health UM procedures and processes, complaints, and appeals. The BHS UM Medical Director is involved with the UM decision-making criteria, decision support tools and behavioral health guidelines. The UM Medical Director co-chairs the UM Committee with the UM Unit Manager.
Required Qualifications:
- Current valid unrestricted CA license issued by the Medical Board of California or the Osteopathic Medical Board of California.*
- Successful completion** of an accredited residency program, Accreditation Council for Graduate Medical Education or American Osteopathic Association in a Psychiatric medical specialty area (i.e., Board Eligible).
- Possession of valid Drug Enforcement Agency registration with the United States Department of Justice (Special Condition).
*Applicants possessing a valid license to practice medicine issued from another state within the United States of America may apply, but if selected, the candidate will NOT be appointed/hired until they obtain a valid license to practice medicine issued by the Medical Board of California or the Osteopathic Medical Board of California.
**Applicants enrolled in a residency program may apply, but if selected, the candidate will NOT be appointed/hired until they demonstrate successful completion of a residency program accredited by the Accreditation Council for Graduate Medical Education or American Osteopathic Association in a Psychiatric medical specialty area.
Qualifications Preferred:
- Seven (7) years of BH Clinical Practice experience.
- Two (2) years of utilization management experience, for example in a hospital, as a Medical Director, or as part of a Behavioral Health or Mental Health Plan review team.
- Proven leadership, problem-solving and the ability to manage multiple priorities.
- Results-oriented and the ability to take ownership for initiatives and collaborate with a team to achieve established goals.
- Basic knowledge of CPT coding and guidance
Position specifics:
- 1.0 FTE position (0.6 FTE UM medical director plus 0.4 clinical time in a low-barrier clinical setting - i.e., street, behavioral health access center)
- Hours: 8:30a-5p
- Hybrid (3 days in-person, 2 days remote) but subject to change due to operational needs and departmental remote work policy
- Clientele: safety net, Medi-Cal/uninsured, severely mentally ill, dual diagnosis, homeless/housing-unstable
- Location: 887 Potrero Ave and 1380 Howard St
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