Vice President, Behavioral Health Clinical Operations and Product Development

UnitedHealth Group•Eden Prairie, MN

13h•Hybrid

About The Position

The Vice President of Product - Utilization Management (UM) and Case Management (CM) will lead the strategic direction, modernization, and performance of enterprise-wide clinical product and operation platforms supporting our behavioral health benefits business. This role is designed for a senior executive with deep experience in large-scale, highly regulated managed care environments - particularly those operating at national scale with complex payer, provider, and regulatory dynamics. This is a cross functional leadership role that partners enterprise wide improving access, optimize service utilization, and enhance outcomes for members with complex behavioral health needs. The VP will assume full ownership of UM and Case Management product strategy, including platform evolution, workflow optimization, automation enablement, regulatory alignment, and measurable operational performance improvement. This executive will work directly with the CEO, CMO and senior leadership to transform behavioral health UM and CM capabilities into competitive differentiator and enterprise growth driver. If you are located within the 30-minute commutable range to Minneapolis or Washington, D.C, you will be required to work in the office a minimum of four days per week.

Requirements

10+ years of progressive leadership experience in health plan clinical operations, medical management, or Behavioral Health Management
Deep experience with enterprise-scale behavioral health Utilization Management and/or Case Management platforms
Experience operating within large, matrixed healthcare organizations
Solid understanding of behavioral health authorization processes and regulatory frameworks
Demonstrated success modernizing complex, high-volume clinical operations systems
Proven executive presence with the ability to influence across clinical, operational, and technical leadership
Proven record of building and leading high-performing product teams

Nice To Haves

Experience in national behavioral health managed care environments
Experience integrating analytics, workflow automation, or AI-enabled decision support into UM/CM systems
Experience driving transformation initiatives within scaled, multi-state healthcare organizations
Exposure to value-based care models and performance-based contracts

Responsibilities

Define and execute a multi-year product vision for Utilization Management and Case Management across behavioral health lines of business
Align product strategy with enterprise growth objectives, value-based care initiatives, and client/payer requirements
Translate strategic goals into disciplined product roadmaps with measurable ROI
Establish KPIs tied to authorization turnaround time, denial reduction, clinical appropriateness, care coordination efficiency, and member/provider satisfaction
Advance whole-person product design that integrates behavioral and physical health services
Lead modernization of complex, high-volume UM, and CM workflows in a regulated behavioral health environment
Drive digitization and automation of prior authorization, concurrent review, discharge planning, and care coordination processes
Expand virtual care pathways for mild-moderate condition management
Integrate analytics and decision-support tools to enhance clinical consistency and operational efficiency
Ensure scalability across multi-state regulatory environments and diverse payer contracts
Ensure product alignment and capabilities support NCQA, URAC, CMS, and state-level compliance standards
Partner with Clinical and Compliance leadership to maintain audit readiness and documentation integrity
Develop governance processes for policy-to-workflow translation within systems
Partner closely with Technology to ensure disciplined delivery within a matrixed organization
Collaborate with Operations leadership to drive adoption, change management, and measurable productivity gains
Support Business Development and client-facing teams by positioning UM and CM capabilities as market differentiators
Partner with Network Management to expand value-based purchasing arrangements for Behavioral Health providers
Present strategy, investment priorities, and performance outcomes to executive leadership and Board stakeholders
Build and lead a high-performing BH Product Management team
Drive transformation by aligning structure, talent, and operating model to enterprise strategy
Mentor product leaders capable of operating in complex, cross-functional environments
Foster a culture of accountability, clinical integrity, and innovation