Behavioral Health Sciences Health Plan Assistant Medical Director
- Position Type
Leaders support and promote the work of the WPMG Board and the WPMG President. They will:
- Be active, engaged, responsible partners in a variety of partnerships in making our Integrated Delivery System and our Enterprise successful.
- Implement KPWA business strategies and initiatives of the WPMG Board.
- Represent WPMG to a variety of audiences both internal and external.
- Set high standards for themselves and the medical group, both around performance and around leadership style. Lead with integrity and respect.
- Support a high performing medical group by setting clear expectations, reviewing outcomes, managing performance, and rewarding excellence.
- Listen, understand and appropriately advocate for the key issues of the medical group.
- Work collaboratively across departments and service lines to achieve the unified goals of service excellence, and quality care and affordability.
- Ensure financial viability by understanding and responding to unwarranted variation and by managing resources strategically.
- Encourage, reward and share best practice innovations.
- Promote and support professional development and career satisfaction of front line MD teams.
- Effectively use daily management system.
- Meet WPMG compliance and code of conduct requirements.
PRINCIPAL DUTIES & RESPONSIBILITIES
In partnership with the Manager, Care Management ensures that outstanding service, clinical, financial and staff satisfaction goals are met in the contracted external delivery of mental health and chemical dependency services. Supports the BHA in both the inpatient and outpatient behavioral health utilization and care management activities. Assists in providing training and clinical decision support to BHS nursing & care coordination staff who provide both transitional and care management and hospital liaison nurse services, to include consultation re: the various behavioral health medical decision-making and appeal processes in the organization.
- Provides development, implementation, and ongoing evaluation of criteria, training of BHA staff and physician reviewers and maintenance of the Kaiser Permanente BHS Clinical Review Criteria.
- Provides clinical review of requests for coverage authorization of inpatient, outpatient, specialty procedure services, and requests for behavioral health medication authorization requests,
- Provides direct communication/coordination with external providers (e.g. peer-to-peer reviews for utilization management) regarding ongoing care, while educating providers and staff, and orienting them to the review criteria and process.
- Ensure that the organizational vision and strategic direction are communicated to the front line staff.
- Create, support, and enhance a culture that supports the Kaiser Permanente of Washington mission by leading efforts for effective service delivery planning, enhanced communication, and team-orientation within the delivery system.
- Manage the BHS Health Plan budget allocation to ensure that financial performance is consistent with desired outcomes and is linked to execution of the Washington Permanente Medical Group and Kaiser Foundation Health Plan of Washington business plans.
- Translate and communicate key work, critical issues, and key decisions to front line staff.
- Develop and foster strategies for increasing highly effective physician leadership.
- Create, support, and enhance a culture that supports the Kaiser Permanente of Washington mission by leading efforts for effective delivery system design, enhanced communication, and team-orientation within the delivery system.
- Lead initiatives to develop, execute, and maintain an environment that fosters collaboration and supports unified goals for service and care quality in BHS and between Kaiser Foundation Health Plan of Washington and Washington Permanente Medical Group.
Operational Excellence and Quality
- Optimize the care experience for the patient by promoting a healthcare system with aligned values and incentives.
Medical Group Brand & Image
- Actively promote Kaiser Permanente as the best place to practice and receive care within Kaiser Permanente and to the community.
Medical degree plus completion of approved residency training in psychiatry. Training expectations include Adaptive Leadership and Facilitative Leadership.
Recommended training options include M & M, ACPE electives, and UW Certification in Medical Management.
LICENSES, CERTIFICATIONS OR OTHER ESSENTIAL QUALIFICATIONS
Must possess a current un-restricted license in the state of Washington and be credentialed by KPWA. Must become board certified within three years of employment.
Three years’ experience in a medical staff leadership position that included one or more of the following: performance management of direct reports, budget responsibility, working in and/or leading a multi-disciplinary leadership team, working in a managed care environment. One year of the above experience requirement may be offset by demonstrated competency resulting from formal leadership/management training or significant community leadership experience
At least five years of recent, successful, continuous experience in providing medical and management leadership in a multidisciplinary, managed care behavioral health service.
Understanding of health maintenance organizations, managed care environments, and modern healthcare management in an integrated group practice setting, including thorough knowledge of industry trends and medical staff personnel functions and management. Skills should include fiscal management, human resource management, strategic planning, and performance evaluation, as well as outstanding verbal, written and presentation skills. Must be an innovative thinker, with the ability to constructively challenge and lead change within the medical group.
Proven ability to lead and manage medical group members while achieving strategic objectives. Demonstrated ability as a physician executive to apply business and medical skills to create and achieve successful Behavioral Health delivery system outcomes.
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