Behavioral Health Clinical Program Manager

UnitedHealth Group•New York, NY

3h•Remote

About The Position

The Clinical Program Manager oversees a remote team of Behavioral Health Care Advocates responsible for utilization management (UM) and case management (CM) of inpatient and outpatient Behavioral Health services. UM is performed via an inbound telephonic queue and requires team members to work a holiday rotation. Case managers work directly with members both telephonically and in the field. The schedule is Monday – Friday, 8a – 5p EST and may include working some holidays. If you are located in New York, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

Licensed Clinician in the State of New York with one of the following licensures. Licenses must be active and unrestricted. Licensed Clinical Social Worker (LCSW) Licensed Mental Health Counselor (LMHC) Licensed Psychologist (LP) Registered Nurse (RN) with 5+ years of Behavioral Health experience
6+ years of Behavioral Health experience including Mental Health and Substance Use Disorders (SUD)
5+ years of experience working with Children / Adolescents
3+ years of management experience in a Behavioral Health setting
3+ years of experience with New York public and commercial mental health and substance abuse services delivery system
Experience overseeing documentation in Electronic Medical Records (EMR)
Experience with Medicare and NY Medicaid regulations
Intermediate proficiency in Microsoft Office Suite, including MS Excel
Ability to work holidays based on business needs
Dedicated, distraction-free workspace and access to high-speed internet in home
Residency in New York

Nice To Haves

Experience working in a Managed Care Organization (MCO)
Experience working with the New York provider network
Experience managing clinical and non-clinical phone queues
Knowledge of evidence-based practices and procedures
Solid customer service orientation
Familiarity with prior authorizations, concurrent reviews, and appeal processes
Familiarity with case management services
Demonstrated competence in clinical care management, solid leadership and organization skills, interpretation of State and federal laws, and regulations relevant to the mental health program area

Responsibilities

Oversight of utilization management of adults, adolescents and children as well as dual eligible Medicare/Medicaid populations with SMI, SUD, co-occurring physical health, co-occurring disorders of MH and SUD, and co-occurring mental health and/or substance use disorders
Manages and is accountable for professional employees and supervisors
Sets team direction, resolves problems, and provides guidance to members of team
May oversee work activities of other supervisors
Adapts departmental plans and priorities to address business and operational challenges
Influences or provides input to forecasting and planning activities
Oversight of new product implementations
Initiating process for state initiatives and directives
Updating and creation of Quick Reference Guides
Oversight and coordination of care with internal and external partners
Experience interfacing with regulatory agencies
Interview, hire and onboard new employees
Review reports to insure team member adherence to established benchmarks
Cover for management team as needed
Foster relationship with leadership and medical directors