Clinical Program Manager, Case Management Lead

2 days ago

Buffalo, New York, United States UnitedHealth Group Full time
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.

As a Clinical Program Manager, you will oversee state-contracted Case Management operations for an Under 21 Behavioral Health population.

You will be responsible for 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.

This role offers the flexibility to work remotely* from Upstate New York, where you will be required to reside.

Key Responsibilities:
  1. Manage and supervise Behavioral Health Care Managers in field/facility-based roles.
  2. Set team direction, resolve clinical problems, and provide guidance to team members.
  3. Monitor, manage, and control operational and performance metrics in conjunction with established program value targets.
  4. Adapt departmental plans and priorities to address business and operational challenges.
  5. Influence or provide input to forecasting and planning activities.
  6. Develop solutions to address new and often complex customer requirements that address operational, clinical, and customer needs.
  7. Ensure audits are conducted, standards are met, and successful outcomes are achieved.
  8. Review operational and performance metrics regularly and drive action plan development and execution.
  9. Ensure site remains compliant with all applicable regulatory and accreditation requirements (NCQA, URAC, and New York State regulations).
  10. Collaborate across OCHS and UHG, including medical, site directors, senior leaders, sales, account management, product organization, and other stakeholders.

You will 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.

Required Qualifications:

  1. Active, unrestricted, independent behavioral health licensure in the State of New York, able to supervise lesser licensure: LCSW, LMHC, LMFT, or LP.
  2. 5+ years of High-Risk Behavioral Health Case Management experience with the Under 21 population.
  3. 3+ years of supervisory or management experience, including performance management functions (i.e., hiring, performance evaluations, corrective action plans, etc.).
  4. 1+ years of experience working with adult populations.
  5. Highly proficient in Microsoft Word, Excel, and PowerPoint.
  6. Access to install secure, high-speed internet and a dedicated workspace at home.
  7. Reside in Upstate New York.

Preferred Qualifications:

  1. 5+ years of post-licensure diversified experience: psychiatric, chemical dependency, or outpatient therapy, with an emphasis in differential diagnosis.
  2. 1+ years of HARP experience.
  3. Experience in a field-based position.
  4. Experience working at an MCO or with the Medicaid population.
  5. Experience in a position serving members with complex trauma.
  6. Experience working for an insurance company or other managed care setting.
  7. Experience with accreditation requirements (NCQA, URAC, and New York State regulations).
  8. Demonstrated ability to develop strategic plans, attainable goals, drive performance, and achieve targets.

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

New York Residents Only: The salary range for this role is $88,000 to $, 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 k contribution (all benefits are subject to eligibility requirements).

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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