UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.

Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.

Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health. UnitedHealth Military & Veterans Services is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.   We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the South.    Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever.  Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions.    It's not just business as usual.  It is one of our proudest endeavors.    If you're ready to help make health care work better for those who serve our nation.  If you are smart, creative, and committed.  If you want to make a difference.  Consider being part of the elite team at UnitedHealth Military & Veterans Services.   The Behavioral Health Associate Medical Director works actively to implement and administer medical policies, disease and medical case management programs, utilization management programs, integrated physician services, quality assurance, appeals and grievances, and regulatory compliance programs with medical service and delivery systems to ensure the best possible quality health care for TRICARE beneficiaries. Accountability for ensuring that initiatives focus on affordability, clinical excellence, TRICARE medical management program requirements and are implemented and successfully managed to achieve performance expectations.  This position requires working closely with utilization management on such tasks as concurrent review and prior authorization review.  This position may also work with Case Management, Disease Management and Community Care Management  programs for clinical consultation and training.  The MD contributes to quality improvement opportunities regarding medical expense programs and clinical programs (CM, DM and CCM) that impact medical expense or program integrity. The Behavioral Health Associate Medical Director for UMVS also provides leadership to clinical staff through case consultation, case review and training.  Provides feedback on clinical performance to senior leaders with plans for clinical performance improvement. The impact of work is at the operational level for TRICARE.  The Behavioral Health Associate Medical Director will collaborate with other Medical Directors to enhance integrated training, consultation and service delivery. SUMMARY OF JOB RESPONSIBLITIES: The Behavioral Health Associate Medical Director reports to the Senior Behavioral Health Medical Director and Vice President of Behavioral Health within the Medical Management Services.   OUTLINE OF ESSENTIAL JOB RESPONSIBILITIES/FUNCTIONS TO INCLUDE BUT NOT LIMITED TO: 1. Develops, coordinates and participates in medical management program design, development, implementation, oversight and monitoring as a medical leader within UMVS/TRICARE team: Implements and executes standards of practice for TRICARE. Assures adherence to UHG and MHS/DoD and Behavioral Health clinical practice guidelines. Works collaboratively with the Medical management senior leaders in the development and implementation of medical expense management initiatives and medical management program development. Participates in evaluation and management of behavioral/medical practices within the requirements of a Multi-Function Peer Review Organization. Works with the VP, Behavioral Health Services to ensure adherence to medical management performance standards including quality, utilization and program integrity. Plans and facilitates training and development of clinical staff to improve performance. Provides for and recommends clinical program enhancements and quality improvements that adhere to the TRICARE requirements and reflect emerging clinical solutions and best evidences based practices. Supports, communicates and facilitates TRICARE wide clinical programs and policies. Provides clinical education to clinical staff to ensure TRICARE medical management program success Analyzes population-based reports to refine management activities, investigate and define variation, and ensure conformance to expected standards and targets. Accountabilities include contributing to medical & clinical processes with a focus on implementing plans of care that meet accepted guidelines and protocols and ensure that optimal and appropriate medical & clinical services are provided.  Ensures compliance with policies, procedures, bylaws, regulatory requirements, and best practice guidelines. Participates in the production of setting performance standards for clinical staff that aligns with program standards and the TRICARE contract. Monitors, assesses, reviews and evaluates clinical employee performance based on the established standards. Works with the VP Behavioral Services and Medical Directors to monitor, evaluate and manage the department trend analysis, and develop the approach and interventions to improve performance. .   2. Communicates effectively. Provides clear and concise verbal and written instructions to ensure that instructions are understood. Complete peer to peer communication, as required Provide beneficiary case consultation for providers, MTF providers and staff, and UMVS clinical staff Listens and asks for feedback from staff, physicians and customers. Contributes to information so that TRICARE network providers are kept up to date on changes that are occurring. Addresses healthcare issues appropriately. Uses the computer system in order to obtain beneficiary, clinical, research, and physician information.   3. Consults and coordinates with health care providers working in other departments and in other business units across UHG. ·        Provides assistance to the health care providers by answering questions regarding beneficiary care. ·        Educates and interacts with network and group providers as well as clinical and case management staff regarding utilization practices and effective resource management. ·        Works in coordination with the health care providers and case managers on high risk beneficiaries to put the most appropriate treatment plan in place for beneficiaries.   4. Works with all other staff in UMVS as a member of the team Ensures that TRICARE staff  understand the goals and objectives of the MHS for TRICARE beneficiaries and assists senior leadership to lead teams and adhere to the goals to comply with TRICARE requirements Updates staff on a regular basis, as appropriate. Participates in fulfilling the mission, vision, goals and objectives of the organization. Oversees and participates on committees within TRICARE and UHG. Ensures a safe work environment for staff who directly interact with beneficiaries   5. Participate in the development and implementation of the TRICARE clinical quality management program Ensures consistent and continual monitoring of quality of care delivered. Contributes to investigation of selected cases reported as deviating from accepted standards and takes appropriate actions. Participate in the HEDIS-like quality measure data extraction, reviews, and analysis.  Provide recommendations for improvement of HEDIS-like measures as established within in TRICARE and other quality metrics set by UMVS. Reviews completed charts on a regular basis as part of the Multi-function Peer Review Organization activities and for UMVS clinical staff monitoring and performance oversight. Provides and receives consistent feedback on the quality of care being delivered. Ensures URAC, NCQA and other regulatory standards are met as they apply to UMVS and TRICARE. Abides by policies, procedures and bylaws.       This is an opportunity to share in something special; a chance for all of us to serve, to excel, and to know that we've made a difference for those families who have made our nation stronger.  Qualifications:   ·         Unrestricted USA Medical Licensed Physician required (or willing to obtain one) ·         Board Certified in Adult or Child Psychiatry specialty required ·         5+ years clinical practice experience required ·         Utilization Management experience required ·         Excellent telephonic communication skills; excellent interpersonal communication skills. ·         Ability to develop relationships with network and community physicians; Military Treatment Facility physicians; and other providers. ·         Strong knowledge of managed care industry. ·         Excellent project management skills. ·         Data analysis and interpretation skills. ·         Ability to focus on key metrics. ·         Excellent presentation skills for both clinical and non clinical audiences. ·         Familiarity with current medical issues and practices. ·         Creative problem solving skills. ·         Strong team player and team building skills. ·         Consultation skills including clinical mentoring and coaching skills. ·         Proven Quality Management experience       Demonstrates personal and professional integrity in dealings with others     Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.