Senior Psychiatrist, Medical Leadership in Utilization Management
2 months ago
Position Overview: This role is part of a newly established unit operating under the guidance of the Director of Behavioral Health Services Managed Care and the Utilization Management Unit Manager. The selected candidate will provide essential clinical leadership, direction, and support for the team, collaborating closely with the UM Unit Manager as Co-Chair of the Utilization Management Committee. This position is currently set at 0.6 Full-Time Equivalent (FTE), with the potential to expand to 1.0 FTE as the unit develops and operational efficiency improves.
Key Responsibilities: The Utilization Management Medical Director will serve as the designated physician responsible for the development and evaluation of the San Francisco Department of Public Health Behavioral Health Services Utilization Management program. This role includes providing clinical oversight of UM activities and offering consultation to UM Clinical Reviewers as necessary. The Medical Director will analyze data and reports alongside the UM Unit Manager to identify necessary actions and make evidence-based recommendations for clinical care and best practices.
The Medical Director will also assist with member behavioral health UM procedures, address complaints and appeals, and contribute to the development of UM decision-making criteria, decision support tools, and behavioral health guidelines. Additionally, this role includes co-chairing the UM Committee with the UM Unit Manager.
Required Qualifications:
- Possession of a current, valid, unrestricted medical 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 specialty area recognized by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association (Board Eligible).
- Valid registration with the Drug Enforcement Agency (DEA) of the United States Department of Justice.
Preferred Qualifications:
- A minimum of seven years of clinical practice experience in behavioral health.
- At least two years of experience in utilization management, whether in a hospital setting, as a Medical Director, or as part of a Behavioral Health or Mental Health Plan review team.
- Demonstrated leadership skills, problem-solving abilities, and capacity to manage multiple priorities effectively.
- Results-driven with a strong sense of ownership for initiatives and the ability to collaborate with a team to meet established objectives.
- Basic understanding of CPT coding and related guidelines.
Position Specifics:
- 0.6 FTE as UM Medical Director, with an additional 0.4 FTE allocated for clinical duties in a low-barrier clinical environment.
- Standard working hours from 8:30 AM to 5:00 PM.
- Hybrid work model with a combination of in-person and remote work, subject to operational needs.
- Clientele includes safety net populations, Medi-Cal/uninsured individuals, those with severe mental illness, dual diagnosis, and homeless or housing-unstable individuals.
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Mountain View, California, United States San Francisco Department of Public Health Full timePosition Overview: This role is part of a newly established unit operating under the guidance of the Director of Behavioral Health Services Managed Care and the Utilization Management Unit Manager. The ideal candidate will offer clinical leadership, mentorship, and support to the team while collaborating closely with the UM Unit Manager as Co-Chair of the...
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