Job Description

Job Title: Senior Clinical Director, Substance Use Services
Job ID: 88176742
Status: Full-Time
Regular/Temporary: Management
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Behavioral Integration
Location: 600 Grant St, Pittsburgh PA 15219

Description

The Senior Clinical Director of Substance Use Services is responsible for enhancing the quality and efficiency of the substance use treatment delivered to UPMC Health Plan members. The Senior Clinical Director provides guidance for clinical and operational aspects of a variety of programs, including enhancing the training supervision, and skill sets of clinical staff, enhance the focus on substance use treatment in a variety of clinical programs including EAP and workman's compensation services, developing strategies to enhance the quality and accessibility of provider services, and enhancing performance on quality metrics such as engagement and retention in substance use treatment services practitioners in the field. This includes significant responsibility for quality management of substance use treatment services and for assuring the adequacy of the provider network for the clinical needs of UPMC Health Plan members. The Senior Clinical Director also participates in company leadership policy decisions and strategic planning.

Responsibilities:

  • Develops and maintains effective relationships with providers.
  • Assures effective and appropriate utilization of the various levels of care in the provider network.
  • Review the clinical aspects of cost and utilization reports generated by Medical Management Information System.
  • Acts as a liaison for UPMC Health Plan with community physicians, hospital staff, and other professionals and agencies with regard to substance use services.
  • Ensures the quality of treatment and related services provided by Health Plan professional staff, through participation (directly or by designee) in the ongoing quality management and audit processes.
  • Implements quality management programs and continues education activities.
  • Interfaces with Health Plan clinical staff and, in conjunction with medical directors, provide direction for clinical staff, especially for members with concurrent substance use and other medical disorders.
  • Works with Provider Relations to enhance the working relationship between UPMC Health Plan and the providers in its network.
  • Supports provider satisfaction with the care management process.
  • Supports member satisfaction with the care management process.
  • Assures clinical involvement in the development, approval, and review of all medical necessity review criteria policies, procedures, and protocols governing substance use care.
  • Plays significant role as interface with employers and other payers.
  • Advises senior management on the development and review of programs, positions, and budgets having an impact on clinical substance use services.
  • Ensures the quality of substance use treatment provided to UPMC Health Plan members.
  • Enhance family and consumer engagement and education.
  • Provides direction to the Quality Management Programing designing and evaluating protocols.

Qualifications

  • Minimum 10 years clinical experience.
  • Doctorate degree from an accredited school in a relevant field or Master's degree in a related field.
  • Unrestricted License in Pennsylvania.
  • Experience in Behavioral Health treatment and program development.
  • At least 5 years of management experience preferred.
  • Experience in managed care setting preferred.
  • Ability to develop and implement clinical policies.
  • Ability to maintain effective professional liaison with all levels of executive and medical staff, including professional and institutional providers of care.
  • Ability to implement programs of quality care analysis, peer review, and professional education.

    Licensure, Certifications, and Clearances:

    UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $0 / hour

Union Position: No

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