Director of Case Management / Behavioral Health Coordinator – Hybrid - Maricopa County, AZ

UnitedHealth Group•Phoenix, AZ

2d•Hybrid

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. To apply clinical and behavioral health knowledge and work in collaboration for all enrollees identified as eligible to receive Arizona Long Term Care System (ALTCS) services in which behavioral health services are integrated with clinical and social supportive services, as a model of care to ensure enrollee needs are met in the most cost-effective manner. Provide support across the LTC case management program and ensure the overall LTC Behavioral Health contractual adherence through monitoring, auditing, and training occur. The Director of Case Management/Behavioral Health Coordinator is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). This includes case management, coordination of care, problem-solving at the member, family, and provider level and medical/behavioral health management consulting. Function may also be responsible for providing health education, coaching, review/approval of service plans and leading projects. Hybrid position which will require Phoenix office-based duties, remote work and about 25%25 travel in the regions served. This position follows a hybrid schedule with two to three in-office days per week based on business needs.

Requirements

Current, unrestricted Licensed Behavioral Health Professional in Arizona
5+ years serving individuals who are elderly and/or individuals with physical or developmental disabilities and with an SED or SMI designation
5+ years of management experience
Supervisory and training experience
Basic knowledge of ALTCS/ Medicare / Medicaid regulations
Working knowledge of Microsoft Word, Excel, and PowerPoint
Computer efficiency
Located in Maricopa County, Arizona
Ability to work a Hybrid schedule which includes 2-3 days in the Phoenix office based on business needs
Ability to travel up to 25%25 of the time in assigned regions in Arizona
Driver’s License and access to reliable transportation

Nice To Haves

Behavioral Health experience
Long-term care experience
Home Health experience
Managed Care experience
Care Coordination experience
Proven solid written / grammar and communication skills, excellent time management skills, the ability to master new skills and ideas, able to adapt to change, and exhibit flexibility
Proven ability to function independently and responsibly with minimal need for supervision
Proven flexible and able to meet short timelines
Demonstrate initiative in achieving individual, team, and organizational goals and objectives
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Excellent Communication skills and ability to interrelate with individuals at various levels and in various functional areas throughout the organization and to develop effective business relationships
Working collaboratively with providers, as well as with internal plan management and Medical Directors in setting direction and strategic planning to develop, implement and monitor action plans to modify care delivery patterns and reduce expenses
Monitor the Court Ordered Treatment process to ensure accurate and timeliness occurs with legal and clinical requirements
Monitor the Child and Family Team (CFT) facilitation of quarterly Clinical Connection meetings for licensed LTC staff, promote collaboration and best practices
Supervise the LTC Coordinator for the Office of Human Rights, monitoring portal compliance and Case Manager integration of the person providing Special Assistance’s integration into care planning
Oversee transitions from the Regional Behavioral Health Authority (RBHA) into Long Term Care services for members with an SMI designation
Develops annual goals and objectives to achieve appropriate reductions in medical expenses that correlate with continuous performance and quality of care improvement efforts
Provide training to new and existing Case Management staff and providers about behavioral health services, programs and processes
Oversee the High Risk Behavioral Health case management managerial staff and Behavioral Health Professionals
Serves as a mentor, monitors adherence to state contract requirements and performance measure outcomes
Serves as the key Behavioral Health Services/Case Management resource and consultant to internal and external customers. Form strategic relationships which will support program growth, expansion and the development of new models/programs
Lead and support our LTC case management department staff and Health Plan membership. Ensure overall LTC Behavioral Health Medicaid contractual adherence through monitoring, auditing, reporting and training
Creates a team oriented management environment, enhancing the integration between behavioral, clinical and operations sections of medical affairs
Review program descriptions and consultation with potential providers joining the network. Complete provider visits to review additional contract requirements for placements with integrated behavioral supports
Review the Behavioral Health Network to reduce out of state placements and/or actively stay involved in any out of state placement for behavioral health services
Develops clear goals and objectives for performance management and effectively communicates accountability
Ensures standardized execution of workflow processes, such as authorizations, adherence to documentation requirements and analyzing outcomes of standardized audits for AHCCCS, HSAG, NCQA and HEIDIS purposes
Responsible for department policies and procedures, training of LTC Case Management staff and external providers, and day-to-day support clinical support, including Behavior Health and substance use consultations
Act as the Liaison for children in Department of Child Safety (DCS) custody