Clinical Program Manager, Case Management Lead

4 weeks ago


Buffalo, New York, United States UnitedHealth Group Full time
Job Summary

As a Clinical Program Manager, you will oversee the state-contracted Case Management operations for an Under 21 Behavioral Health population. This role involves managing staff, ensuring compliance with audits, managing state-based initiatives, adhering to NCQA/HEDIS measures, and providing administrative services to support the ongoing work of Optum Case Management New York.

Key Responsibilities
  • Manage and supervise Behavioral Health Care Managers in field/facility-based roles
  • Set team direction, resolve clinical problems, and provide guidance to team members
  • Monitor, manage, and control operational and performance metrics in conjunction with established program value targets
  • Adapt departmental plans and priorities to address business and operational challenges
  • Influence or provide input to forecasting and planning activities
  • Develop solutions to address new and complex customer requirements
  • Ensure audits are conducted, standards are met, and successful outcomes are achieved
  • Review operational and performance metrics regularly and drive action plan development and execution
  • Ensure site compliance with all applicable regulatory and accreditation requirements
  • Collaborate across OCHS and UHG, including medical, site directors, senior leaders, sales, account management, product organization, and other stakeholders

Requirements
  • Active, unrestricted, independent behavioral health licensure in the State of New York, able to supervise lesser licensure
  • 5+ years of High-Risk Behavioral Health Case Management experience with the Under 21 population
  • 3+ years of supervisory or management experience, including performance management functions
  • 1+ years of experience working with adult populations
  • Highly proficient in Microsoft Word, Excel, and PowerPoint
  • Access to install secure, high-speed internet and a dedicated workspace at home
  • Reside in Upstate New York

Preferred Qualifications
  • 5+ years of post-licensure diversified experience: psychiatric, chemical dependency, or outpatient therapy, with an emphasis in differential diagnosis
  • 1+ years of HARP experience
  • Experience in a field-based position
  • Experience working at an MCO or with the Medicaid population
  • Experience in a position serving members with complex trauma
  • Experience working for an insurance company or other managed care setting
  • Experience with accreditation requirements
  • Demonstrated ability to develop strategic plans, attainable goals, drive performance, and achieve targets

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