Clinical Program Manager, Case Management Lead
1 week ago
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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