Behavioral Clinical Program Manager - National Remote

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 Provider Enablement Consultant (PEC) is responsible for the ongoing clinical management and quality oversight of Optum Behavioral Health's value-based programs. The PEC will be responsible for developing relationships with participating behavioral health providers and facilities, and driving a quality improvement process to improve quality, improve clinical outcomes, increase efficiency and reduce overall benefit expense. The PEC will monitor provider performance and compliance with contractual obligations, provide tools to assist with performance and compliance, and is accountable for driving provider performance improvement. As the single point of clinical contact for a provider, the PEC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within Optum and the participating provider.

The PEC must demonstrate solid clinical and analytic skills, solid oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities/groups and/or providers. This PEC will work closely with Care Advocacy Operations, Affordability, Network Management teams and other relevant departments to affect desired outcomes with the participating provider as it relates to treatment for our membership.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Build and effectively maintain relationships with provider leadership and key clinical staff
• Regularly facilitate oversight meetings with providers to monitor, present, and discuss performance
• Monitor provider performance on program metrics, quality outcomes and adherence to contract requirements
• Identify performance improvement opportunities through analysis of operational data, clinical outcome data and utilization/claims data
• Communicate with providers to initiate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with contractual obligations
• Initiate and monitor Quality Improvement Plans to drive performance
• Conduct provider program audits and provide feedback and results
• Support high performing providers such that performance remains at a high level
• Provide clinical and care coordination support
• Deliver education and training
• Interface with other OHBS departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement

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:

• Licensed Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D./Psy.D. level Psychologist, or Registered Nurse with behavioral health experience. Licenses must be active and unrestricted
• 3+ years post-licensure direct behavioral health clinical experience
• 2+ years working in Managed Care setting
• Proven dedicated/ Private workspace from home

Preferred Qualifications:

• 3+ years of Managed Care experience
• Proven working knowledge of Public Sector benefit plans
• Experience in interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change
• Demonstrated ability to balance contractual and clinical considerations
• Proven solid computer skills and intermediate level proficiency with MS Office (Excel knowledge required)
• Proven excellent time management and prioritization skills
• Proven solid relationship building and influencing skills
• Proven solid written and verbal communication skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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