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Senior Psychiatrist for Utilization Management

2 months ago

Mountain View, California, United States San Francisco Department of Public Health Full time

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 ideal candidate will provide clinical leadership, support, and direction for the team, collaborating closely with the UM Unit Manager as Co-Chair of the Utilization Management Committee.

Key Responsibilities:

  • Oversee the development and evaluation of the SFDPH Behavioral Health Services Utilization Management program.
  • Provide clinical oversight for Utilization Management activities and offer consultation to Clinical Reviewers as necessary.
  • Review data and reports with the UM Unit Manager to identify necessary actions and make evidence-based recommendations.
  • Assist with member behavioral health Utilization Management procedures, including handling complaints and appeals.
  • Engage in the development of decision-making criteria, decision support tools, and behavioral health guidelines.
  • Co-chair the Utilization Management Committee alongside the UM Unit Manager.

Required Qualifications:

  1. Possession of a current, valid, unrestricted California medical license.
  2. Completion of an accredited residency program in a psychiatric specialty area.
  3. Valid registration with the Drug Enforcement Agency.

Preferred Qualifications:

  • Minimum of seven years of clinical practice experience in behavioral health.
  • At least two years of experience in utilization management, ideally in a hospital or as a Medical Director.
  • Demonstrated leadership and problem-solving skills with the ability to manage multiple priorities effectively.
  • Results-oriented mindset with a collaborative approach to achieving goals.
  • Basic understanding of CPT coding and guidelines.

Position Details:

  • 1.0 FTE position (0.6 FTE in Utilization Management and 0.4 FTE in clinical practice).
  • Standard working hours are from 8:30 AM to 5:00 PM.
  • Hybrid work model with a combination of in-person and remote work, subject to operational needs.
  • Focus on serving a diverse clientele, including those who are uninsured or facing severe mental health challenges.