For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.This position is responsible for Optum behavioral health operations, contract management and relationships with customers, including UnitedHealthcare Community & State (UHC C&S), state Medicaid Bureau, providers, advocacy organizations and other key stakeholders. The Director coordinates with all functional areas of shared services partners, including but not limited to clinical operations, quality management, network development and management, provider relations, member outreach, education and member services, contract compliance and operations including claims and reporting. This position directly impacts financial performance and achievement of overall public sector goals.If you live in New Mexico, you will have the flexibility to work remotely as you take on some tough challenges.Primary Responsibilities:
Coordinate day to day operations (including claims, clinical, regulatory, network, etc.) to achieve goals and ensure compliance of all functional areas supporting behavioral health in the market
Lead and direct teams to ensure compliance with contract deliverables
Guide stakeholders and matrix partners in the effective delivery of services, achievement of metrics, and avoidance of all contract penalties
Lead the development of action plans to remedy any findings from internal or external audits, utilization reports, as well as provider, member, Health Plan or state concerns by engaging with shared services leadership, identifying linkages with other Health Plan corrective action plans (CAPs), and formulating go-forward strategies with Health Plan
Has full delegation to represent the Health Plan for all BH functions and make decisions accordingly
Develop annual strategic plan incorporating affordability, network strategy and clinical innovation leveraging broader OBH strategy and including local state and Health Plan issues
Identify and capitalize on opportunities to communicate and collaborate with stakeholders through presentations, written materials, and direct interactions
Provide thought leadership to C&S Health Plan leadership and state Medicaid agency around behavioral health for any regulatory actions; Participate in C&S Executive/Senior Leadership meetings
Provide leadership and direction in the development of appropriate risk management strategies. Work closely with the customer, Optum and UnitedHealth Group team members, providers, and stakeholders to ensure timely and appropriate implementation of these strategies
Assist with forecasting revenue or savings opportunities associated with product development initiatives
Lead the definition and development of local market performance against contractual, clinical, and fiscal targets. Identify and analyze local market trends and service gaps; develop mitigation strategies aligned with strategic priorities
Drive innovation across teams to ensure aligned, cohesive progress across technology, marketing, and service operations
Collect and deliver required clinical operations customer reporting
Provide leadership and opportunity to sales and business development staff around market priorities and strategies to foster growth and account retention
Engage with Optum Behavioral Health and Enterprise Clinical services Clinical leadership and Operations team on all clinical activities and initiatives; provide thought leadership to C&S Health Plan and the State around clinical innovation
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.Required Qualifications:
Independent, current, and unrestricted state license to provide behavioral health services in the state. (MD, DO, APRN, psychologist, licensed independent social worker (LISW) professional clinical counselor (PCC), independent marriage and family therapist) with 5+ years of experience in the provision of supervision of treatment services for mental illness and substance use disorder
7+ years of managerial and administrative experience in public sector, managed care or behavioral health care
5+ years of experience in an administrative position in a mental health organization
Experience in public sector mental health or non-profit community mental health, with knowledge of Medicaid/Medicare populations
Experience working with New Mexico payers or providers
Experience managing Profit and Loss (P&L); responsibility for a large budget, etc.
Knowledge and understanding of New Mexico overall behavioral health system that includes mental health, alcohol and drug addictions, and developmental disabilities services
Thorough understanding of and experience with managed care principles, models, and financing
Proficiency with Microsoft Office Suite
Demonstrated ability to work collaboratively and influence others
Proven solid data analytic skills; ability to identify gaps, trends, and mitigation strategies
Demonstrated excellent verbal and written communication skills
Proven solid planning, organizational and monitoring skills
Live in the state of New Mexico
Willingness to travel within the state of New Mexico up to 25% of the time
Preferred Qualifications:
Experience in a recovery-oriented delivery system
Proven ability to achieve goals in a highly matrixed environment
Demonstrated abilities to build strong and effective teams, facilitate staff working together collaboratively, and grow and retain top talent
Demonstrated leadership effectiveness and project management experience
Proven solid customer service orientation
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.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.Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.