Clinical Program Manager, Care Management - Remote

UnitedHealth Group•Eden Prairie, MN

1d•Remote

About The Position

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Program Manager has responsibility for oversight of care management teams for a dedicated customer account, Medica. The program serves a spectrum of members with behavioral health needs. Oversight includes management of staff, compliance with audits, management of customer-based initiatives, adherence to NCQA / HEDIS measures, and all administrative services. You’ll enjoy the flexibility to work remotely as you take on some tough challenges. Residency in the Twin Cities, MN Metro is required.

Requirements

Master’s or Doctoral degree in Psychology, Social Work, Counseling, or a related field
Active, unrestricted independent MN license in a behavioral health field: LP, LPCC, LICSW, or LMFT
5+ years post licensure experience in a behavioral health setting focused on mental health and substance use disorder treatment
2+ years of management / leadership experience
Proficient in Microsoft Office Suite
Ability to attend in-person meetings based on business needs in the western Twin Cities metro
Access to secure high-speed internet and a dedicated, distraction-free workspace at home

Nice To Haves

Experience working in managed care environment
Experience with medical or behavioral health collaboration within different organizations
Experience doing care coordination, case management, and/or utilization review
Proven data analysis and project management skills

Responsibilities

Manage care management and UM programs for adults, adolescents, and children with special focus on discharge planning, supporting a family system, supporting members with complex mental health and substance use disorder conditions
Provide clinical supervision, training, oversight, performance evaluation, and direction to Team Leads, Care Advocates, and Wellness Coordinators
Leadership responsibilities for care advocacy center that include participation and engagement in site management meetings, planning, and facilitating trainings and meetings
Ensure department goals are communicated clearly and goals are met or exceeded through team effort
Manage and use data to inform programmatic changes and report out on findings, including data analytics
Monitor daily operations of the team to ensure the team is following all applicable protocols, policies, workflows, and documentation requirements
Ensure the team is performing member care through documentation audits, call audits, and responding to member concerns
Handle escalated situations and cases with a goal of swift resolution
Lead clinicians who are tasked with working with members with behavioral health diagnosis, helping to facilitate care and creative treatment planning for those members to improve their overall quality of life in a cost-effective manner
Participate and collaborate with customer projects and initiatives
Lead functional or segment teams, projects, or implementations
Ongoing management and evaluation of the Medica Behavioral Health programs