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 and help people live healthier lives while doing your life's best work.(sm) The Behavioral Health Practice Management Specialist must demonstrate strong clinical and analytic skills, strong oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities. They will be responsible for the development of relationships with Community Mental Health Centers (CMHCs), groups, and facilities as well as other outpatient behavioral health group entities. They will monitor their clinical effectiveness and efficiency, as well as compliance with contractual obligations. This Specialist will work closely with Care Advocacy Operations, Affordability and Network Management teams to affect desired outcomes with facilities / programs as it relates primarily to treatment for our public sector membership. The Specialist will partner with outpatient facilities / groups that operate outside of typical practice or billing patterns which will be subject to a specific set of interventions. The Practice Management Specialist's role with these providers / groups / facilities will be to coordinate a strategic effort that includes Clinical Operations, Network Services, Program and Network Integrity, and Affordability with the goal of designing and delivering interventions aimed at addressing outlier practice patterns, while improving provider performance, quality and clinical outcomes. Primary Responsibilities:Interface with senior leaders (e.g., CEO) at high volume facilities / groups Communicate with facilities / groups to initiate appropriate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with care advocacy processes and contractual obligations Support those high performing facilities such that performance remains at a high level Identify facility outliers through analysis of clinical outcomes data, utilization / claims data Measure improvement of program performance over time Measure improvement of program performance over time Modify interventions as appropriate Initiate and monitor Corrective Action Plans (CAPs) as appropriate to affect performance Interface with other Optum departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement
Required Qualifications:Licensed Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling OR a Licensed Ph.D. level Psychologist, OR an RN with behavioral health experience License must be independent, and active and unrestricted Permanent residence in the state of Florida 3+ years of Care Coordination / Management and / or Utilization Review experience in a Managed Care setting Knowledge of CPT / HCPCS codes Strong analytical skills with knowledge of or willingness to learn analytics software such as Microsoft Excel Dedicated space for home office set up and access to high speed internet services Access to reliable transportation that will enable you to travel to provider locations within a designated area (up to 25%)Preferred Qualifications:Direct clinical experience (Post Licensure) Knowledge of the public sector, i.e., Medicaid Strong communication skills, written and verbal Ability to balance contractual and clinical considerations Ability to work in a self - directed manner, seeking guidance on only the most complex tasks Capacity to provide solutions for non - standard and / or complex issues solutions Excellent time management and prioritization skills Ability to establish and maintain strategic relationships with facilities senior leadership teams Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: LMFT, IMFT, LICSW, LISW, LCSW, LP, LPC, LCPC, LPCC, RN, Social Worker, Therapist, Counselor, Case Manager, Case Worker, Care Advocate, quality, HEDIS, Work from home, Telecommute, Florida
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.