Clinical Delegation Oversight Director-Remote-State of Washington

UnitedHealth Group•Seattle, WA

19h•$112,700 - $193,200•Remote

About The Position

Optum Behavioral Health, part of the Optum family of businesses, is seeking a Clinical Delegation Oversight Coordinator to join our team. As a member of the Optum Behavioral Care team, you’ll be an integral part of our vision to make healthcare better for everyone. Serving as the primary liaison to Behavioral Health Administrative Service Organizations (BH-ASO), the Clinical Delegation Oversight Coordinator plays a vital, outward-facing role engaging with the Health Care Authority (HCA), BH ASOs and internal stakeholders. This position ensures effective oversight of services delegated to the BH ASOs, employing a streamlined, standardized framework to support consistency and excellence across all partnerships. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. during Pacific Time Zone business hours 8am-5pm as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. 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.

Requirements

Unrestricted clinical licensure in the state of Washington (LMHC, LMFT, LICSW, Psychologist, RN with BH expertise)
5+ years of experience in public sector (Medicaid or Medicare) contract oversight within behavioral health
5+ years of cross functional leadership experience in a matrix environment
3+ years of experience in performing clinical audits
Demonstrated expertise in public speaking, confidently presenting complex information to diverse audiences
Demonstrated ability to use a PC in a Windows environment, including email and Microsoft Office applications
Ability to work Pacific Time Zone hours 8am-5pm
Ability to travel up to 10%25 as needed for annual audits/corrective plan remediation

Nice To Haves

Resident of the State of Washington

Responsibilities

Lead and oversee delegated audit activities as defined in the Washington (WA) Delegation Oversight Program and auditing tool
Build collaborative relationships with the HCA, BH ASOs and internal stakeholders
Oversee delegation audit activities as outlined in the WA Delegations Oversight Program for approximately ten operational functional areas
Identify and ensure delegation subject matter experts (SMEs) monitor progress for timely compliance. In conjunction with delegation SMEs, implement corrective action plan(s), review outcomes and adjust until goals are met
Identify and develop with internal teams’ reporting/dashboard or score cards that inform the delegated entities of their performance and provide clinical/operational shaping opportunities to improve contractual/clinical outcomes
Perform periodic clinical audits
Schedule and complete, at a minimum, quarterly performance meetings with delegees. If performance warrants, develop, implement and monitor the closure of collaborative/corrective improvement plans
Prepare and deliver necessary reporting, both written and verbal, demonstrating oversight of compliance
Monitor and participate in regulatory changes that affect delegated entities for WA Medicaid. Ensure delegee’s are compliant and establish methods to measure compliance