Clinical Leader for Behavioral Health Utilization Management
6 days ago
This is a newly formed unit operating under the direction of the Director of BHS Managed Care and the UM Unit Manager.
The ideal candidate will provide clinical leadership, guidance, and support for the team, working in partnership with the UM Unit Manager as Co-Chair of the UM Committee. The position is currently 0.6 FTE, with an anticipated increase to 1.0 FTE as the unit grows and efficiency improves.
The Utilization Management (UM) Medical Director plays a key role in SFDPH BHS UM program development, evaluation, and clinical oversight of UM activities. This includes consulting with UM Clinical Reviewers as needed, reviewing data and reports with the UM Unit Manager, and making recommendations based on evidence-based clinical care and promising practices.
Key Responsibilities:
- Clinical Leadership: Provide guidance and support to the team, ensuring high-quality clinical services are delivered.
- Program Development: Contribute to the development and implementation of the UM program, aligning with departmental goals and objectives.
- Clinical Oversight: Ensure the quality and effectiveness of UM activities, collaborating with the UM Unit Manager and other stakeholders.
Requirements:
- A 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 in a Psychiatric medical specialty area.
- Possession of valid Drug Enforcement Agency registration with the United States Department of Justice.
Preferred Qualifications:
- Seven years of BH Clinical Practice experience.
- Two 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 ability to manage multiple priorities.
- Results-oriented and ability to take ownership for initiatives and collaborate with a team to achieve established goals.
- Basic knowledge of CPT coding and guidance.
Salary Information:
Based on industry standards and San Francisco's cost of living, we estimate this position's salary range to be between $250,000 and $350,000 per year, depending on experience and qualifications. This figure includes base salary and benefits, taking into account the location and required expertise.
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