Clinical Director jobs at Acadia Healthcare

Responsibilities Clinic Director- IOP mental health clinic Horizon Health is seeking a Program Director for our BRAND NEW outpatient mental health clinic called Thousand Branches Wellness in Cleveland, OH. Responsibilities include but are not limited to assessment, development, implementation, and management of outpatient services. Under the guidance of UHS Corporate Outpatient Department this position will be accountable for overseeing, supervising, and monitoring daily operations ensuring clinical and budgetary expectations are met. Responsibilities: * Site Leadership * Responsible for the management and oversite of all Employees * Lead Marketing and Business Development Efforts - Digital, print and in person * Collaborative efforts with external support entities * Organizing and prioritizing workloads to meet deadlines * Coordinate and manage multiple projects and tasks * Able to work in a fast-paced environment * Monitor and manage client satisfaction through standardized measures * Clinical oversight, support, and supervision * Recruitment, Onboarding, and training of new clinicians * Curriculum and Service Line Development * Group Facilitation and Observation to ensure curriculum integrity is maintained * Referral Management, Assessments, group facilitation and direct individual client contact * Interdisciplinary Treatment Team communication * Maintain confidentiality through good judgement * Implement and manage systems to ensure effective communication with clients, families, referral sources and other relevant entities * Regular Documentation Audits * Performance Improvement and Risk Monitoring * Data Analysis for trend identification and ongoing program development * Adherence to safety policies and procedures * Manage and provide routine reports as requested * Fiscal Responsibilities and Corporate deadlines * Census Management * Utilization Review * FTE and Expense Management * Oversight of physical space * Hospitality Needs * Safe work environment Benefit Highlights: * Competitive Compensation * Excellent Medical, Dental, Vision, and Prescription Drug Plan * 401(K) with company match and discounted stock plan * Long and Short-term Disability * Flexible Spending Accounts; Healthcare Savings Account * Life Insurance * Career development opportunities within the company * Tuition Assistance * Rewarding work environment - Enjoy going to work everyday! About Thousand Branches Wellness: Thousand Branches Wellness will provide outpatient mental services including Intensive Outpatient (IOP), Medication Management, and Individual Therapy. A subsidiary of Universal Health Services (UHS), one of the largest and most respected providers of hospital and behavioral healthcare services, Thousand Branches Wellness is seeking an experienced Clinic Director to support the building of a new program and oversee the day-to-day operations of our premier clinic. Under the guidance of the UHS Corporate Outpatient Department, this position will be accountable for overseeing, supervising, and monitoring daily operations ensuring clinical and budgetary expectations are met. Thousand Branches Website: ********************************************************************* About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. For more information email Courtney Eble, Horizon Health Recruiter at ******************************* Qualifications * Master's Degree or higher * Active OH Clinical License (LCSW, LMFT or LPCC) * Able to provide clinical supervision * 5-8 years of behavioral healthcare leadership experience Preferred Skills * Experience with Management of clinical and clerical aspects of a behavioral health office * Understanding of TX State and The Joint Commission Requirements and Regulations for outpatient Behavioral Health Services * Digital, Print and in Personal Marketing * Professional Written and Verbal Communication Skills * Knowledge of EMR Utilization Required Behavioral Health Knowledge * Applicable state laws pertaining to Outpatient Behavioral health services * Corporate expectations, policies, and procedures EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. Avoid and Report Recruitment Scams We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R - Respect I - Innovation S - Stewardship E - Excellence Director of Clinic Operations Summary The Director of Clinic Operations (DCO) provides administrative oversight and supervision of clinic operations leadership at multiple PHS locations who oversee clinic staff and direct day-to-day clinic operations. The DCO oversees programs, processes and resources that align with PHS policies, goals and objectives that include continuous improvement, ensuring standards are met. The DCO is responsible for ensuring delivery of high-quality patient services, financial and operational results of areas of oversight. A Day in the Life This reflects management's assignment of essential functions. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time. Leadership · Driving results by taking initiative, managing execution, and focusing on overall performance. · Make sound business decisions by understanding the business from multiple stakeholders' perspective, make complex decisions and ensure timely decisions that advance the organization. · Engaging people through building collaborative relationships, optimizing diverse talent, and influencing people. · Holding oneself accountable by fostering trust, being open by demonstrating self-awareness and self-development, and remaining flexible and adaptable. · Maximize contribution to ensure meeting company strategic goals, key performance indicators or initiatives. Responsibilities: · Foster a high-performance culture through effective leadership, training, and performance management, ensuring the team is motivated to provide efficient service delivery and high-quality patient care. · Engages staff and providers to promote team building and contribute to the success of the clinic's quality, fiscal, staff and patient experience. · Drive strategic initiatives aligned with PHS' long-term vision, focusing on growth opportunities and overall practice performance. · Drive consistent daily operational outcomes e.g., patient service productivity, utilization, staff ratios, maximize capacity, wait-time, panel management, resources allocation, etc. · Leads and collaborates interdepartmentally to drive successful short-term and long-term projects to successful outcome. · Develop and implement operational processes, policies, and procedures with a focus on efficiency and scalability, establishing mechanisms to incorporate best practice findings into standards of practice. · Assures standardization of operations aligned with PHS priorities or expectations. · Maximize efficiency and productivity through process analysis and interdepartmental collaboration. · Consistently meets financial goals through optimizing revenue and implementing cost-control measures, · Consistently meets population health quality goals including value-based care contracts with state or federal e.g., Medicare Shared Savings Program (MSSP) and Medicaid Value Based Care (CPC); and Patient Centered Medical Home (PCMH) certification and Uniform Data System (UDS) measures are met in accordance with HRSA. · Ensure regulatory and safety compliance through implementation and oversight of best practices in all operations. · Prepared and participates effectively in mandatory audits - adheres to quality assurance and regulatory standards from PHS, federal, state, and other agencies, including OSHA, HRSA, PCMH, and ODH. · Independently analyze reports and data with action to enhance operational performance. · Responds promptly to persistent issues with effective action plans including continuous process improvement to get back on track. · Other duties assigned. Core Competencies · Understanding the Business: customer focused (patient and staff), financial acumen, business insight, tech savvy · Making Complex Decisions: decision quality and manages complexity with competing needs, balancing stakeholders · Taking Initiative: action oriented, resourcefulness · Managing Execution: directs work, plans and assigns, optimizes work processes · Focusing on Performance: ensures accountability, drives results with focus on outcomes · Building Collaborative Relationships: collaborates · Optimizing Diverse Talent: attracts top talent, retains top talent, develops top talent, values differences · Influencing People: communicates effectively, drives engagement, organizational savvy by balancing people and organization with approach, persuades, drives vision and purpose · Being Authentic: instills trust · Being Open: demonstrates self-awareness, self-development · Being Flexible and Adaptable: being resilient and nimble learner Requirements Success Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience Required: 5+ years' experience within the same scope of responsibilities within an ambulatory operations leadership role. At least 5 years of experience directly supervising other leaders. Strong healthcare business acumen and positive record with provider relations. Preferred: bachelor's or master's degree in health care administration, business administration or related field. Previous experience working with external stakeholders or partners delivering patient care services, multi-specialty or school-based health care. Language Skill Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Computer Skills To perform this job successfully, an individual should have the ability to gain knowledge to be proficient of current electronic health record, practice management system and Microsoft 365 including Outlook, Excel and Word. Other Applicable Requirements Strong communicator and listener to patients and associates. Strong interpersonal skills (friendly, caring, patient). Strong verbal/written communication skills. Strong organizational skills and attention to detail. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand, walk, use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is occasionally exposed to fumes or airborne particles; toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate. Affirmative Action/EEO Statement It is the policy of Primary Health Solutions to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management Program and performing peer reviews as necessary. This individual will interact directly with and offer clinical, procedural, or administrative recommendations to psychiatrists and other behavioral health providers, medical physicians and nurses, clinical professionals, and/or state agencies who care for members, or consult on various processes and programs. The Medical Director is part of a leadership team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on health care system improvement opportunities. They are responsible for maintaining the clinical integrity of the program, including timely peer reviews, appeals and consultations with providers and other community-based clinicians, including general practitioners, and will work collaboratively with the Health Plan Medical Director, Clinical, Network and Quality staff. At Optum, our clinical vision drives the team to improve the quality of care our consumers receive. If you are located in New Jersey, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Collaborate with the Utilization Management and Care Management teams to ensure delivery of cost-effective quality care that incorporates recovery, resiliency and person-centered services + Partner with the internal UM and CM teams, Health Plan, NJ state and the Providers + Level of Care guidelines and utilization management protocols + Oversight and management, along with the Clinical Director and Clinical Program Director, utilization review, management and care coordination activities + Provide clinical oversight to the clinical staff, oversee the management of services at all levels of care in the benefit plan + Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Doctor of Medicine or Osteopathy + Current license to practice as a physician without restrictions in the state of New Jersey + Currently reside in the state of New Jersey + Board certified in Psychiatry + Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery + Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management + Computer and typing proficiency, Microsoft Outlook and Teams, and data analysis **Preferred Qualifications:** + 3+ years of experience as a practicing psychiatrist post residency + Managed care experience + Experience in public sector delivery systems and experience in state specific public sector services + Experience working with community-based programs and resources designed to aid the State Medicaid population + Familiar with Substance Use Disorders, ASAM and treatment modalities including MAT (Medication Assisted Treatment) *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $258,000 to $423,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. If you reside in Florida, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations + Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements + Engage with requesting providers as needed in peer-to-peer discussions + Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews + Participate in daily clinical rounds as requested + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy + Communicate and collaborate with other internal partners You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Doctor of Medicine or Osteopathy + Current active, unrestricted license to practice as a physician without restrictions in the state of FL + Current board certification in Internal Medicine or Family Practice + 5+ years of clinical practice experience after completing residency training + Substantial experience in using electronic clinical systems + Solid belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices + PC skills, specifically using MS Word, Outlook, and Excel + Ability to participate in rotational weekend and holiday call coverage + Currently reside in Florida **Preferred Qualifications:** + Hands-on experience in utilization review + Clinical practice experience in the last 2 years + Data analysis experience + Data analysis and interpretation experience and skills + Sound knowledge of the managed care industry + Proven excellent presentation skills for both clinical and non-clinical audiences *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. If you reside in Florida, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations + Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements + Engage with requesting providers as needed in peer-to-peer discussions + Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews + Participate in daily clinical rounds as requested + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy + Communicate and collaborate with other internal partners You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Doctor of Medicine or Osteopathy + Current active, unrestricted license to practice as a physician without restrictions in the state of FL + Current board certification in Internal Medicine or Family Practice + 5+ years of clinical practice experience after completing residency training + Substantial experience in using electronic clinical systems + Solid belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices + PC skills, specifically using MS Word, Outlook, and Excel + Ability to participate in rotational weekend and holiday call coverage + Currently reside in Florida **Preferred Qualifications:** + Hands-on experience in utilization review + Clinical practice experience in the last 2 years + Data analysis experience + Data analysis and interpretation experience and skills + Sound knowledge of the managed care industry + Proven excellent presentation skills for both clinical and non-clinical audiences *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Description: Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R - Respect I - Innovation S - Stewardship E - Excellence Director of Clinic Operations Summary The Service Line Director (SLD) provides administrative oversight and supervision of clinic and behavioral health operations leadership at multiple PHS locations who oversee clinic staff and direct day-to-day operations. The SLD oversees programs, processes and resources that align with PHS policies, goals and objectives that include continuous improvement, ensuring standards are met. The SLD is responsible for ensuring delivery of high-quality patient services, promotes an integrated and team-based care models, ensures financial and operational results of areas of oversight. A Day in the Life This reflects management's assignment of essential functions. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time.? Leadership Driving results by taking initiative, managing execution, and focusing on overall performance. Make sound business decisions by understanding the business from multiple stakeholders' perspective, make complex decisions and ensure timely decisions that advance the organization. Engaging people through building collaborative relationships, optimizing diverse talent, and influencing people. Holding oneself accountable by fostering trust, being open by demonstrating self-awareness and self-development, and remaining flexible and adaptable. Maximize contribution to ensure meeting company strategic goals, key performance indicators or initiatives. Responsibilities: Foster a high-performance culture through effective leadership, training, and performance management, ensuring the team is motivated to provide efficient service delivery and high-quality patient care. Engages staff and providers to promote team building and contribute to the success of the clinic's quality, fiscal, staff and patient experience. Drive strategic initiatives aligned with PHS' long-term vision, focusing on growth opportunities and overall practice performance. Drive consistent daily operational outcomes e.g., patient service productivity, utilization, staff ratios, maximize capacity, wait-time, panel management, resources allocation, etc. Leads and collaborates interdepartmentally to drive successful short-term and long-term projects to successful outcome. Develop and implement operational processes, policies, and procedures with a focus on efficiency and scalability, establishing mechanisms to incorporate best practice findings into standards of practice. Assures standardization of operations aligned with PHS priorities or expectations. Maximize efficiency and productivity through process analysis and interdepartmental collaboration. Consistently meets financial goals through optimizing revenue and implementing cost-control measures, Consistently meets population health quality goals including value-based care contracts with state or federal e.g., Medicare Shared Savings Program (MSSP) and Medicaid Value Based Care (CPC); and Patient Centered Medical Home (PCMH) certification and Uniform Data System (UDS) measures are met in accordance with HRSA. Ensure regulatory and safety compliance through implementation and oversight of best practices in all operations. Prepared and participates effectively in mandatory audits - adheres to quality assurance and regulatory standards from PHS, federal, state, and other agencies, including OSHA, HRSA, PCMH, and ODH. Independently analyze reports and data with action to enhance operational performance. Responds promptly to persistent issues with effective action plans including continuous process improvement to get back on track. Other duties assigned. Core Competencies Understanding the Business: customer focused (patient and staff), financial acumen, business insight, tech savvy Making Complex Decisions: decision quality and manages complexity with competing needs, balancing stakeholders Taking Initiative: action oriented, resourcefulness Managing Execution: directs work, plans and assigns, optimizes work processes Focusing on Performance: ensures accountability, drives results with focus on outcomes Building Collaborative Relationships: collaborates Optimizing Diverse Talent: attracts top talent, retains top talent, develops top talent, values differences Influencing People: communicates effectively, drives engagement, organizational savvy by balancing people and organization with approach, persuades, drives vision and purpose Being Authentic: instills trust Being Open: demonstrates self-awareness, self-development Being Flexible and Adaptable: being resilient and nimble learner Requirements: Success Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience Required: 3+ years' experience in behavioral health programs or operations in a leadership role with demonstrated results including previous managerial experience supervising or directing the work of other leaders. Strong provider relations experience. 3+ years' experience working or integrating behavioral health services with medical services is preferred. Preferred: bachelor's or master's degree in health care administration, business administration or related field. Previous experience working with external stakeholders or partners to deliver patient care services. Language Skill Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Computer Skills To perform this job successfully, an individual should have the ability to gain knowledge to be proficient of current electronic health record, practice management system and Microsoft 365 including Outlook, Excel and Word. Other Applicable Requirements Strong communicator and listener to patients and associates. Strong interpersonal skills (friendly, caring, patient). Strong verbal/written communication skills. Strong organizational skills and attention to detail. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand, walk, use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is occasionally exposed to fumes or airborne particles; toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate. Affirmative Action/EEO Statement It is the policy of Primary Health Solutions to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R - Respect I - Innovation S - Stewardship E - Excellence Director of Clinic Operations Summary The Service Line Director (SLD) provides administrative oversight and supervision of clinic and behavioral health operations leadership at multiple PHS locations who oversee clinic staff and direct day-to-day operations. The SLD oversees programs, processes and resources that align with PHS policies, goals and objectives that include continuous improvement, ensuring standards are met. The SLD is responsible for ensuring delivery of high-quality patient services, promotes an integrated and team-based care models, ensures financial and operational results of areas of oversight. A Day in the Life This reflects management's assignment of essential functions. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time.? Leadership Driving results by taking initiative, managing execution, and focusing on overall performance. Make sound business decisions by understanding the business from multiple stakeholders' perspective, make complex decisions and ensure timely decisions that advance the organization. Engaging people through building collaborative relationships, optimizing diverse talent, and influencing people. Holding oneself accountable by fostering trust, being open by demonstrating self-awareness and self-development, and remaining flexible and adaptable. Maximize contribution to ensure meeting company strategic goals, key performance indicators or initiatives. Responsibilities: Foster a high-performance culture through effective leadership, training, and performance management, ensuring the team is motivated to provide efficient service delivery and high-quality patient care. Engages staff and providers to promote team building and contribute to the success of the clinic's quality, fiscal, staff and patient experience. Drive strategic initiatives aligned with PHS' long-term vision, focusing on growth opportunities and overall practice performance. Drive consistent daily operational outcomes e.g., patient service productivity, utilization, staff ratios, maximize capacity, wait-time, panel management, resources allocation, etc. Leads and collaborates interdepartmentally to drive successful short-term and long-term projects to successful outcome. Develop and implement operational processes, policies, and procedures with a focus on efficiency and scalability, establishing mechanisms to incorporate best practice findings into standards of practice. Assures standardization of operations aligned with PHS priorities or expectations. Maximize efficiency and productivity through process analysis and interdepartmental collaboration. Consistently meets financial goals through optimizing revenue and implementing cost-control measures, Consistently meets population health quality goals including value-based care contracts with state or federal e.g., Medicare Shared Savings Program (MSSP) and Medicaid Value Based Care (CPC); and Patient Centered Medical Home (PCMH) certification and Uniform Data System (UDS) measures are met in accordance with HRSA. Ensure regulatory and safety compliance through implementation and oversight of best practices in all operations. Prepared and participates effectively in mandatory audits - adheres to quality assurance and regulatory standards from PHS, federal, state, and other agencies, including OSHA, HRSA, PCMH, and ODH. Independently analyze reports and data with action to enhance operational performance. Responds promptly to persistent issues with effective action plans including continuous process improvement to get back on track. Other duties assigned. Core Competencies Understanding the Business: customer focused (patient and staff), financial acumen, business insight, tech savvy Making Complex Decisions: decision quality and manages complexity with competing needs, balancing stakeholders Taking Initiative: action oriented, resourcefulness Managing Execution: directs work, plans and assigns, optimizes work processes Focusing on Performance: ensures accountability, drives results with focus on outcomes Building Collaborative Relationships: collaborates Optimizing Diverse Talent: attracts top talent, retains top talent, develops top talent, values differences Influencing People: communicates effectively, drives engagement, organizational savvy by balancing people and organization with approach, persuades, drives vision and purpose Being Authentic: instills trust Being Open: demonstrates self-awareness, self-development Being Flexible and Adaptable: being resilient and nimble learner Requirements Success Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience Required: 3+ years' experience in behavioral health programs or operations in a leadership role with demonstrated results including previous managerial experience supervising or directing the work of other leaders. Strong provider relations experience. 3+ years' experience working or integrating behavioral health services with medical services is preferred. Preferred: bachelor's or master's degree in health care administration, business administration or related field. Previous experience working with external stakeholders or partners to deliver patient care services. Language Skill Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Computer Skills To perform this job successfully, an individual should have the ability to gain knowledge to be proficient of current electronic health record, practice management system and Microsoft 365 including Outlook, Excel and Word. Other Applicable Requirements Strong communicator and listener to patients and associates. Strong interpersonal skills (friendly, caring, patient). Strong verbal/written communication skills. Strong organizational skills and attention to detail. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand, walk, use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is occasionally exposed to fumes or airborne particles; toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate. Affirmative Action/EEO Statement It is the policy of Primary Health Solutions to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Optum Radiation Oncology Medical Director will provide clinical guidance to help implement a next-generation comprehensive Radiation Oncology solution which will successfully meet clinical, quality, and financial performance objectives. This solution will help ensure providers deliver high-quality, evidence-based and cost-efficient radiation oncology care for our clients. As such, this role requires an innovative, hands-on, action-oriented clinician. This position will serve as a member of the radiation oncology team dedicated to helping ensure high levels of quality, affordability, and member and provider satisfaction. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Perform utilization review determinations for radiation oncology populations, and support case and disease management teams to achieve optimal clinical outcomes * Speak with providers by phone. This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense * Enhance clinical expertise of the radiation oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies & stakeholders * Deliver the Optum clinical value proposition focused on quality, affordability and service, in support of the sales and growth activities including conducting client presentations and participating in customer consultations * Evaluate clinical and other data (e.g., quality metrics, claims & health record data, utilization data) to identify opportunities for improvement of clinical care and processes * Collaborate with operational and business partners on enterprise-wide research, clinical and quality initiatives to enhance Optum impact in the Radiation oncology field * This remote-work position will require the use of a company provided personal computer, internet access and familiarity with Microsoft Office applications * Rotational weekend/ holiday on-call coverage as scheduled You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * MD or DO with an active, unrestricted medical license * Current board certification in Radiation Oncology * 5+ years of clinical practice experience (inclusive of radiation oncology) * Proficiency with Microsoft Office applications * Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development and/or peer review * Proven ability to quickly gain credibility, influence and partner with staff and the clinical community * Participate in rotational weekend/ holiday on-call coverage as scheduled Preferred Qualifications: * Experience in managed care, quality management or administrative leadership * Experience working with payer guidelines * Experience in client-facing customer relationship management * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations + Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements + Engage with requesting providers as needed in peer-to-peer discussions + Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews + Participate in daily clinical rounds as requested + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy + Communicate and collaborate with other internal partners You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + M.D. or D.O. + Active unrestricted license to practice medicine + Board certification approved by the AMBS or AOBMS specialty + 5+ years of clinical practice experience after completing residency training + Proven sound understanding of Evidence Based Medicine (EBM) + Demonstrated PC skills, specifically using MS Word, Outlook, and Excel **Preferred Qualifications:** + Board certified Surgeon or OBGYN + Licensed in KY, LA, ND, NV or CA is a plus + Compact License + Experience in utilization review + Demonstrated data analysis and interpretation aptitude + Proven innovative problem-solving skills + Proven excellent presentation skills for both clinical and non-clinical audiences + Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $238,000 to $357,500 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Position in this function is responsible, in part, as a member of a team of medical directors, for the overall quality, effectiveness and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and participates in the Quality Improvement programs for the company. The Medical Director also provides/assists in the direction and oversight in the development and implementation of policies, procedures and clinical criteria for all medical programs and services and may serve as a liaison between physicians, and other medical service providers in selected situations. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: + Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations. The focus of the coverage reviews will be various types of musculoskeletal surgical procedures and other medical/surgical services for musculoskeletal procedures including therapy + Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements. Supports compliance with regulatory agency standards and requirements (e.g., CMS, NCQA, URAC, state / federal and third-party payers) + Works with clinical staff to coordinate all the necessary coverage reviews and provides feedback to staff who do portions of the coverage reviews + Engage with requesting providers as needed in peer-to-peer discussions + Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews + Participates in periodic clinical conferences / calls and in ongoing internal performance consistency reviews + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy + Communicate and collaborate with other internal partners + Call coverage rotation. Is available for periodic weekend and holiday coverage as needed for telephonic and remote computer expedited clinical decisions + Participation in Training regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict of Interest, HIPAA, and department specific training as applicable + Good understanding of professional performance measurement and related possible discussions/interventions with selected providers/groups/organizations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + MD or DO with an active, unrestricted medical license + Current, active and unrestricted medical license + Willing to obtain additional licenses as needed + Board Certification in Orthopedic Surgery + 5+ years clinical practice experience post residency + Sound understanding of Evidence Based Medicine (EBM) + Proficient with MS Office (MS Word, Email, Excel, and Power Point) + Proven excellent computer skills and ability to learn new systems and software + Proven excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs and other similar personnel **Preferred Qualifications:** + 2+ years managed care, Quality Management experience and/or administrative leadership experience + Experience in utilization and clinical coverage review + Clinical experience within the past 2 years *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $269,500 to $425,500 annually based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations + Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements + Engage with requesting providers as needed in peer-to-peer discussions + Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy + Communicate and collaborate with other internal partners + Call coverage rotation You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + M.D or D.O. + Active unrestricted license to practice medicine + Board certification approved by the American Board of Medical Specialties (ABMS) + 5+ years of clinical practice experience after completing residency training + Sound understanding of Evidence Based Medicine (EBM) + Proven solid PC skills, specifically using MS Word, Outlook, and Excel **Preferred Qualifications:** + Current licensure in New Mexico, Arizona, Texas, or Tennessee + Willing to obtain additional licensure if needed + Board Certification in Internal Medicine, Family Practice, Surgery, Plastic Surgery but other board certifications considered + Experience in utilization and clinical coverage review + Proven data analysis and interpretation aptitude + Proven innovative problem-solving skills + Demonstrated excellent presentation skills for both clinical and non-clinical audiences + Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together** . Responsible, in part, as a member of a team of medical directors, for the overall quality, effectiveness and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and participates in the Quality Improvement programs for the company. The Medical Director also provides/assists in the direction and oversight in the development and implementation of policies, procedures and clinical criteria for all medical programs and services and may serve as a liaison between physicians, and other medical service providers in selected situations. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations. The focus of the coverage reviews will be various types of musculoskeletal and other medical/surgical services which will include prior authorizations for Pain Management procedures ( e.g. spinal chord stimulators, pain pumps, nerve ablations, facet injections, etc.) + Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements. Supports compliance with regulatory agency standards and requirements (e.g., CMS, NCQA, URAC, state / federal and third-party payers) + Works with clinical staff to coordinate all the necessary UM processes and provides feedback to staff who do portions of the UM reviews + Participation in Training regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict of Interest, HIPAA, and department specific training as applicable + Discusses cases and clinical situations with treating providers telephonically during scheduled hours + Participates in periodic clinical conferences / calls and in ongoing internal performance consistency reviews + Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews + Participate in rotational call coverage. Is available for occasional, periodic weekend and holiday as needed telephonic and remote computer expedited clinical decisions + Provide Clinical support for staff that conduct initial reviews + Good understanding of professional performance measurement and related possible discussions/interventions with selected providers/groups/organizations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current, active, and fully unrestricted medical license + Current Board Certification and must maintain pain subspecialty with specialty in either PM&R or Anesthesia + 5+ years clinical experience post residency in Pain subspecialty + Proficient with MS Office (MS Word, Email, Excel, and Power Point) + Excellent computer skills and ability to learn new systems and software + Excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs and other similar personnel + Participate in rotational call coverage + Must be willing and able to obtain additional medical licenses as needed **Preferred Qualifications:** + License in North Carolina or New Mexico a plus + Experience in managed care UM activities + Must possess leadership skills in working with other physicians, knowledge of the overall medical community and the local / regional managed care environments + Experience with integration of clinical and financial data, development of utilization and performance reporting tools, and communication of performance data to physicians and other health care providers *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience, and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Coverage Review Medical Director is a key member of the Optum Enterprise Clinical Services Team. On the Focused Pharmacy Review team, they are responsible for providing physician support to Optum Rx Pharmacy Team, and to Clinical Coverage Review (CCR) operations, the organization responsible for the initial clinical review of service requests for UnitedHealth Care (UHC). The Medical Director collaborates with Optum Rx and CCR leadership and staff to establish, implement, support, and maintain clinical and operational processes related to outpatient pharmacy and medical coverage determinations. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), with a focus on outpatient pharmacy reviews, and on communication regarding this process with both network and non-network physicians, as well as other UnitedHealth Group departments. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided * Conduct coverage review on some medical cases, based on individual member plan documents, and national and proprietary coverage review guidelines, render coverage determinations, and discuss with requesting providers as needed in peer-to-peer telephone calls * Use clinical knowledge in the application and interpretation of medical and pharmacy policy and benefit document language in the process of clinical coverage review's guidelines * Conduct daily clinical review and evaluation of all service requests collaboratively with Clinical Coverage Review staff * Provide support for CCR nurses, pharmacists, and non-clinical staff in multiple sites in a manner conducive to teamwork * Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants; educates providers on benefit plans and UHC medical policy * Communicate with and assist Medical Directors outside CCR regarding coverage and other pertinent issues * Communicate and collaborate with other departments such as the Inpatient Concurrent Review team regarding coverage and other issues * Is available and accessible to the CCR staff throughout the day to respond to inquiries. Serve as a clinical resource, coach, and leader within CCR * Access clinical specialty panel to assist or obtain assistance in complex or difficult cases * Document clinical review findings, actions, and outcomes in accordance with CCR policies, and regulatory and accreditation requirements * Actively participate as a key member of the CCR team in regular meetings and projects focused on communication, feedback, problem solving, process improvement, staff training and evaluation and sharing of program results * Actively participate in identifying and resolving problems and collaborates in process improvements that may be outside own team * Provide clinical and strategic leadership when participating on national committees and task forces focused on achieving Clinical Coverage Review goals * Ability to obtain additional state medical licenses as needed * Participate in rotational weekend and holiday call coverage * Other duties and goals assigned by the medical director's supervisor You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Active, unrestricted physician license 5+ years of clinical practice experience after completing residency training * Substantial experience in using electronic clinical systems * Participate in rotational weekend and holiday call coverage * Solid belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices * PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: * Current board certification in Gastroenterology, Rheumatology, Hematology-Oncology, Internal Medicine, Family Practice or Emergency Medicine * Hands-on experience in utilization review * Clinical practice experience in the last 2 years * Data analysis experience * Sound knowledge of the managed care industry * Data analysis and interpretation experience and skills * Reside in PST or MST * Excellent presentation skills for both clinical and non-clinical audiences * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** Position in this function is responsible, in part, as a member of a team of medical directors, for the overall quality, effectiveness and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and participates in the Quality Improvement programs for the company. The Medical Director also provides/assists in the direction and oversight in the development and implementation of policies, procedures and clinical criteria for all medical programs and services and may serve as a liaison between physicians, and other medical service providers in selected situations. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations. The focus of the coverage reviews will be various types of musculoskeletal and other medical/surgical services which will include prior authorizations for spine surgery + Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements. Supports compliance with regulatory agency standards and requirements (e.g., CMS, NCQA, URAC, state / federal and third-party payers) + Works with clinical staff to coordinate all the necessary coverage reviews and provides feedback to staff who do portions of the coverage reviews + Engage with requesting providers as needed in peer-to-peer discussions + Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews + Participates in periodic clinical conferences / calls and in ongoing internal performance consistency reviews + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy + Communicate and collaborate with other internal partners + Call coverage rotation. Is available for periodic weekend and holiday coverage as needed for telephonic and remote computer expedited clinical decisions + Participation in Training regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict of Interest, HIPAA, and department specific training as applicable + Good understanding of professional performance measurement and related possible discussions/interventions with selected providers/groups/organizations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current, active and unrestricted medical license + Current Board Certification in Orthopedic Surgery or Neurosurgery + 5+ years clinical experience post residency in Orthopedic Surgery or Neurosurgery to include experience with musculoskeletal/ spine surgery + Sound understanding of Evidence Based Medicine (EBM) + Proficient with MS Office (MS Word, Email, Excel, and Power Point) + Excellent computer skills and ability to learn new systems and software + Excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs and other similar personnel + Willing to obtain additional licenses as needed **Preferred Qualifications:** + Active license in South Carolina, Minnesota or Texas, but candidates with an active license in other states are acceptable + ABMS or other nationally recognized further specialized certifications + Experience in managed care UM activities/ coverage reviews + Possess leadership skills in working with other physicians, knowledge of the overall medical community and the local / regional managed care environments + Experience with integration of clinical and financial data, development of utilization and performance reporting tools, and communication of performance data to physicians and other health care providers No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Clinical Director, you will assists the Executive Director in all functions of clinical oversight of the provider. This includes oversight of the eligibility of patients referred to hospice services and services provided to patients and supervising their care; maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency while maintaining quality of care; and providing motivation and retention of qualified staff. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Compliance with all hospice regulations, laws, policies and procedures, including regulations related to the Medicare and Medicaid hospice benefit, as well as any requirements related to private or managed care insurance * Ensures that the hospice agency employs only qualified hospice personnel * Present on-site during business hours or immediately available by telephone when off-site conducting agency business and available after hours, as needed * Directs the day-to-day clinical operations of the agency including training and orientation, regulatory compliance, interdisciplinary group effectiveness, growth, and education regarding hospice services * Oversees all patient care activities to ensure compliance with current standards of accepted nursing and medical practice and regulatory standards on a constant basis * Promotes hospice education to referral sources and the community at large * Works closely with agency hospice physicians as well as community physicians to drive clinical excellence for patients facing end-of-life * Ensures that patient care services are provided according to the plan of care, as ordered by the physician * Provides clinical oversight and supervision according to licensure type, scope of practice, and state regulatory guidelines * May participate as a member of the hospice agency Governing Body and facilitates Governing Body meetings that support review and discussion of the hospice agency activities regarding clinical care and quality oversight * Acts as liaison between staff, patients, families, the hospice management team and the hospice Governing Body * Provides oversight of hospice billing processes to ensure billing practices meet regulatory requirements and reflect patient care provided * Ensures adequate staffing through recruitment and retention activities * Ensures timely completion of assigned hospice agency staff evaluations * Identifies education needs and ensures adequate clinical and process education for clinical staff * Reviews monthly financials and cost management reports with Executive Director/Executive Administrator relative to all aspects of the operation to ensure that quality patient care is delivered in the most cost effective manner * Assists with oversight of the hospice agency quality assurance performance improvement program, to include use of objective data to improve performance in the areas of improved patient/family care and activities related to patient health and safety. Specific performance improvement activities include, but are not limited to, root cause analysis and development of action plans and focused performance improvement projects * Ensures that staff personnel files are maintained according to state and federal guidelines, as well as accreditation standards, if applicable * Completes required courses through LHC Group learning management system and attends in-services, when applicable * Functions as a preceptor to new hires as needed, and according to discipline-specific licensure guidelines, if applicable * Oversees and/or directly investigates all patient complaints, and alleged or real violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse of a patient. * Oversees and/or directly investigates all patient-related sentinel events * Serves as the infection control contact for the agencies, is responsible for the direction, provision, and quality of infection control services, and effectively enforces infection control practices among agencies to include infection control and isolation protocols according to the CDC, OSHA, and LHC policy * Acts as Emergency Coordinator during emergencies ensuring appropriate plan execution * May act as back-up to the agency Executive Director/Executive Administrator You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current and unrestricted RN licensure in the state of practice * Current CPR certification * Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation Preferred Qualifications: * 3+ years of experience in a hospice, home health, or other health care service delivery system setting * 2+ years of healthcare leadership * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Explore opportunities with Grace Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Clinical Director, you will assists the Executive Director in all functions of clinical oversight of the provider. This includes oversight of the eligibility of patients referred to hospice services and services provided to patients and supervising their care; maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency while maintaining quality of care; and providing motivation and retention of qualified staff. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Compliance with all hospice regulations, laws, policies and procedures, including regulations related to the Medicare and Medicaid hospice benefit, as well as any requirements related to private or managed care insurance + Ensures that the hospice agency employs only qualified hospice personnel + Present on-site during business hours or immediately available by telephone when off-site conducting agency business and available after hours, as needed + Directs the day-to-day clinical operations of the agency including training and orientation, regulatory compliance, interdisciplinary group effectiveness, growth, and education regarding hospice services + Oversees all patient care activities to ensure compliance with current standards of accepted nursing and medical practice and regulatory standards on a constant basis + Promotes hospice education to referral sources and the community at large + Works closely with agency hospice physicians as well as community physicians to drive clinical excellence for patients facing end-of-life + Ensures that patient care services are provided according to the plan of care, as ordered by the physician + Provides clinical oversight and supervision according to licensure type, scope of practice, and state regulatory guidelines + May participate as a member of the hospice agency Governing Body and facilitates Governing Body meetings that support review and discussion of the hospice agency activities regarding clinical care and quality oversight + Acts as liaison between staff, patients, families, the hospice management team and the hospice Governing Body + Provides oversight of hospice billing processes to ensure billing practices meet regulatory requirements and reflect patient care provided + Ensures adequate staffing through recruitment and retention activities + Ensures timely completion of assigned hospice agency staff evaluations + Identifies education needs and ensures adequate clinical and process education for clinical staff + Reviews monthly financials and cost management reports with Executive Director/Executive Administrator relative to all aspects of the operation to ensure that quality patient care is delivered in the most cost effective manner + Assists with oversight of the hospice agency quality assurance performance improvement program, to include use of objective data to improve performance in the areas of improved patient/family care and activities related to patient health and safety. Specific performance improvement activities include, but are not limited to, root cause analysis and development of action plans and focused performance improvement projects + Ensures that staff personnel files are maintained according to state and federal guidelines, as well as accreditation standards, if applicable + Completes required courses through LHC Group learning management system and attends in-services, when applicable + Functions as a preceptor to new hires as needed, and according to discipline-specific licensure guidelines, if applicable + Oversees and/or directly investigates all patient complaints, and alleged or real violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse of a patient. + Oversees and/or directly investigates all patient-related sentinel events + Serves as the infection control contact for the agencies, is responsible for the direction, provision, and quality of infection control services, and effectively enforces infection control practices among agencies to include infection control and isolation protocols according to the CDC, OSHA, and LHC policy + Acts as Emergency Coordinator during emergencies ensuring appropriate plan execution + May act as back-up to the agency Executive Director/Executive Administrator You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current and unrestricted RN licensure in the state of practice + Current CPR certification + Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation **Preferred Qualifications:** + 3+ years of experience in a hospice, home health, or other health care service delivery system setting + 2+ years of healthcare leadership *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** This Behavioral Medical Director offers a unique combination of responsibilities and opportunities. The MD will be the Chief Behavioral Medical Officer for a government program MCO serving roughly 50K individuals. As a member of the Executive Leadership Team, the MD will be the primary behavioral representative for clinical activities, quality improvement, utilization management and integrity, compliance, governmental relations, and policy. The MD will work collaboratively with a behavioral team consisting of an Executive Director, Operations/Clinical Director, dedicated UM and CM professionals, as well as other corporate supports. The MD will be a Population Health thought and innovation leader working with peers from other MCOs, State Government, and the Community. While the MD will support UM, it will be done in collaboration with a larger group of physician peers from our Western Region. Secondly, the MD is aligned with a group of Psychiatrists offering clinical oversight and direction to Optum's Clinical team. As a team member, the Behavioral Health Medical Director will collaborate cross-functionally with other Optum and UHG partners to design, build and test clinical models to drive better outcomes and affordability for members with complex needs including those with substance use disorders, behavioral and medical health conditions, and unmet social determinants of health, with a vision to improve member engagement in clinically, cost-effective care. The Behavioral Medical Director is responsible for providing clinical oversight to medical-behavioral integrated (MBI) multidisciplinary teams working to engage members in their recovery. This team uses data and performance metrics to design prototypes assessing interventions, stratification and impact, cost, provider performance, and value creation. This individual will interact directly with and offer clinical, procedural, or administrative recommendations to psychiatrists and other behavioral health providers, medical physicians and nurses, clinical professionals, and/or state agencies caring for our community. The Behavioral Medical Director is part of a leadership team managing development and implementation of affordable, evidence-based treatments and regional action planning, and advises leadership on health care system improvement opportunities. Case Management activities include utilization management, case consultation, participation in MBI activities, care engagement-clinical rounds, collaboration with, and participation in the development of case management innovation and evolution. The Behavioral Medical Director participates in quality activities to measure value and promote best practices, including reviewing procedures affecting the quality of care for our members. The Behavioral Medical Director reports directly to the Senior Medical Director for the West region. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Ensuring delivery of cost-effective quality care that incorporates evidence-based practices, recovery, resiliency, and person-centered services + Coordination with multiple medical specialties including behavioral, community-based clinicians, specialists, general practitioners, state agencies, and other stakeholders involved in the implementation of a longitudinal care plan + Works as part of an integrated medical-behavioral team that helps coordinate care engagement, care coordination and MBI activities + Provide clinical supervision to the clinical staff, oversee the management of services at all levels of care in the benefit plan + Keep current regarding Evidence Based Practices and treatment philosophies including those that address MBI, equity, trauma-informed care, recovery, and resilience + Maintaining the clinical integrity of the program, including timely peer reviews, documentation, and consultations + Work collaboratively with the Health Plan Executive Leadership Team + Increase interaction, policy making and advocacy with our state partner + Develop collaborative clinical and value-based partnerships w/ providers You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Doctor of Medicine or Osteopathy + Current license to practice as a physician without restrictions in the state of New Mexico + Currently reside in New Mexico + Board certified in Psychiatry + Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management + Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation, and recovery + Computer and typing proficiency, data analysis and organizational skills + Ability to participate in rotational weekend call coverage **Preferred Qualifications:** + Board certification in Child and Adolescent Psychiatry; Addiction experience/training + 3+ years of experience as a practicing psychiatrist post residency + Managed care experience + Experience in public sector delivery systems and experience in state specific public sector services + Experience working with community-based programs and resources designed to aid the State Medicaid population *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $258,000 to $423,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities with Baptist Reynolds Hospice House, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Clinical Director, you will assists the Executive Director in all functions of clinical oversight of the provider. This includes oversight of the eligibility of patients referred to hospice services and services provided to patients and supervising their care; maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency while maintaining quality of care; and providing motivation and retention of qualified staff. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Compliance with all hospice regulations, laws, policies and procedures, including regulations related to the Medicare and Medicaid hospice benefit, as well as any requirements related to private or managed care insurance + Ensures that the hospice agency employs only qualified hospice personnel + Present on-site during business hours or immediately available by telephone when off-site conducting agency business and available after hours, as needed + Directs the day-to-day clinical operations of the agency including training and orientation, regulatory compliance, interdisciplinary group effectiveness, growth, and education regarding hospice services + Oversees all patient care activities to ensure compliance with current standards of accepted nursing and medical practice and regulatory standards on a constant basis + Promotes hospice education to referral sources and the community at large + Works closely with agency hospice physicians as well as community physicians to drive clinical excellence for patients facing end-of-life + Ensures that patient care services are provided according to the plan of care, as ordered by the physician + Provides clinical oversight and supervision according to licensure type, scope of practice, and state regulatory guidelines + May participate as a member of the hospice agency Governing Body and facilitates Governing Body meetings that support review and discussion of the hospice agency activities regarding clinical care and quality oversight + Acts as liaison between staff, patients, families, the hospice management team and the hospice Governing Body + Provides oversight of hospice billing processes to ensure billing practices meet regulatory requirements and reflect patient care provided + Ensures adequate staffing through recruitment and retention activities + Ensures timely completion of assigned hospice agency staff evaluations + Identifies education needs and ensures adequate clinical and process education for clinical staff + Reviews monthly financials and cost management reports with Executive Director/Executive Administrator relative to all aspects of the operation to ensure that quality patient care is delivered in the most cost effective manner + Assists with oversight of the hospice agency quality assurance performance improvement program, to include use of objective data to improve performance in the areas of improved patient/family care and activities related to patient health and safety. Specific performance improvement activities include, but are not limited to, root cause analysis and development of action plans and focused performance improvement projects + Ensures that staff personnel files are maintained according to state and federal guidelines, as well as accreditation standards, if applicable + Completes required courses through LHC Group learning management system and attends in-services, when applicable + Functions as a preceptor to new hires as needed, and according to discipline-specific licensure guidelines, if applicable + Oversees and/or directly investigates all patient complaints, and alleged or real violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse of a patient. + Oversees and/or directly investigates all patient-related sentinel events + Serves as the infection control contact for the agencies, is responsible for the direction, provision, and quality of infection control services, and effectively enforces infection control practices among agencies to include infection control and isolation protocols according to the CDC, OSHA, and LHC policy + Acts as Emergency Coordinator during emergencies ensuring appropriate plan execution + May act as back-up to the agency Executive Director/Executive Administrator You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current and unrestricted RN licensure in the state of practice + Current CPR certification + Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation **Preferred Qualifications:** + 3+ years of experience in a hospice, home health, or other health care service delivery system setting + 2+ years of healthcare leadership *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. \#LHCJobs _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities with Baptist Reynolds Hospice House, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Clinical Director, you will assists the Executive Director in all functions of clinical oversight of the provider. This includes oversight of the eligibility of patients referred to hospice services and services provided to patients and supervising their care; maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency while maintaining quality of care; and providing motivation and retention of qualified staff. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Compliance with all hospice regulations, laws, policies and procedures, including regulations related to the Medicare and Medicaid hospice benefit, as well as any requirements related to private or managed care insurance * Ensures that the hospice agency employs only qualified hospice personnel * Present on-site during business hours or immediately available by telephone when off-site conducting agency business and available after hours, as needed * Directs the day-to-day clinical operations of the agency including training and orientation, regulatory compliance, interdisciplinary group effectiveness, growth, and education regarding hospice services * Oversees all patient care activities to ensure compliance with current standards of accepted nursing and medical practice and regulatory standards on a constant basis * Promotes hospice education to referral sources and the community at large * Works closely with agency hospice physicians as well as community physicians to drive clinical excellence for patients facing end-of-life * Ensures that patient care services are provided according to the plan of care, as ordered by the physician * Provides clinical oversight and supervision according to licensure type, scope of practice, and state regulatory guidelines * May participate as a member of the hospice agency Governing Body and facilitates Governing Body meetings that support review and discussion of the hospice agency activities regarding clinical care and quality oversight * Acts as liaison between staff, patients, families, the hospice management team and the hospice Governing Body * Provides oversight of hospice billing processes to ensure billing practices meet regulatory requirements and reflect patient care provided * Ensures adequate staffing through recruitment and retention activities * Ensures timely completion of assigned hospice agency staff evaluations * Identifies education needs and ensures adequate clinical and process education for clinical staff * Reviews monthly financials and cost management reports with Executive Director/Executive Administrator relative to all aspects of the operation to ensure that quality patient care is delivered in the most cost effective manner * Assists with oversight of the hospice agency quality assurance performance improvement program, to include use of objective data to improve performance in the areas of improved patient/family care and activities related to patient health and safety. Specific performance improvement activities include, but are not limited to, root cause analysis and development of action plans and focused performance improvement projects * Ensures that staff personnel files are maintained according to state and federal guidelines, as well as accreditation standards, if applicable * Completes required courses through LHC Group learning management system and attends in-services, when applicable * Functions as a preceptor to new hires as needed, and according to discipline-specific licensure guidelines, if applicable * Oversees and/or directly investigates all patient complaints, and alleged or real violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse of a patient. * Oversees and/or directly investigates all patient-related sentinel events * Serves as the infection control contact for the agencies, is responsible for the direction, provision, and quality of infection control services, and effectively enforces infection control practices among agencies to include infection control and isolation protocols according to the CDC, OSHA, and LHC policy * Acts as Emergency Coordinator during emergencies ensuring appropriate plan execution * May act as back-up to the agency Executive Director/Executive Administrator You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current and unrestricted RN licensure in the state of practice * Current CPR certification * Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation Preferred Qualifications: * 3+ years of experience in a hospice, home health, or other health care service delivery system setting * 2+ years of healthcare leadership * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. #LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.