Associate Director, Behavioral Health HEDIS Network Strategy

UnitedHealth Group•Eden Prairie, MN

10h•$112,700 - $193,200

About The Position

The Associate Director of Behavioral Health HEDIS Network Strategy leads development and execution of provider network initiatives that improve behavioral health quality outcomes with a primary focus on HEDIS and CMS Core Set measures (e.g., FUH, FUM, FUA). This role translates quality strategy into actionable network interventions and partners closely with behavioral health network providers and provider vendors to improve access, follow-up, and continuity of care. The Associate Director will lead network initiatives and workstreams while collaborating and influencing with cross-functional partners to drive successful cross-matrixed interventions. Key functions focus on: Operational execution within behavioral health networks Provider and facility level performance improvement Behavioral health liaison to medical networks Developing strategic solutions with a measure specific focus (e.g., FUH/FUM/FUA) Defined scope by market, product, or provider segment 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. Explore opportunities at Optum Behavioral Care. We’re revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We’re connecting care to create a seamless health journey for patients across care settings. Join our team, it’s your chance to improve the lives of millions while Caring. Connecting. Growing together.

Requirements

5+ years of related Managed Care experience in healthcare network operations building provider strategies and programs to improve quality, outcomes, and member experience, resulting in reducing avoidable cost
3+ years of Facility/Outpatient Provider Relations experience
3+ years of Network Management experience
3+ years of Strategic Planning experience
2+ years of experience presenting complex subject matter that can be easily understood by general audiences and senior leadership
Experience leading cross-functional teams in a highly matrixed organization

Nice To Haves

Master’s degree in social work, counseling, or clinical psychology
Understanding of NCQA HEDIS Quality Measures
Experience working at Optum Behavioral Health Solutions in Network (Contracting & Provider Relations)
Demonstrated advanced data analytics skills
Demonstrated advanced project management skills
Demonstrated advanced interpersonal and communication skills

Responsibilities

Execute behavioral health network strategies that improve performance on priority HEDIS and Core Set measures.
Partner with network and vendor outpatient, inpatient, and community based behavioral health providers to address access, timely follow-up, and care coordination gaps
Support contracting and incentive strategies tied to behavioral health quality outcomes
Collaborate with Network, Quality, Clinical, and Analytics teams to identify provider level opportunities
Collaborate with medical Network teams on integrated care opportunities
Use performance data to target interventions and monitor improvement
Identify and escalate risks and progress to HEDIS leadership
Support regulatory compliance and readiness related to behavioral health quality, including audits and EQRO reviews
Contribute to provider education and best practice dissemination related to behavioral health HEDIS requirements
Leverage existing and build new relationships with provider associations, facilities, and partners to remove barriers and improve HEDIS performance