Clinical Program Manager, Care Management - Remote
$91.7k - $163.7kUnitedHealth Group
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. Primary 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
- 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
- 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
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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