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- Murfreesboro, TN
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Clinical Director, Behavioral Health - Brentwood, TN
UnitedHealth Group • Murfreesboro, TN
Posted 2 days ago
Our Product Development and Management groups are vital to our success and are leaders in driving the future growth of Optum. Success in these careers relies on many factors - ability to deal with ambiguity, ability to adapt and embrace change, and a long-term commitment to making health care better for everyone. The Consumer Solutions Group within Optum is seeking a Clinical Director, Behavioral Health.
As the Clinical Director, Behavioral Health you will be vital to our success and drive future growth. You will be accountable for the performance of the Behavioral Health clinical team across multiple programs in an assigned area. You will participate in the development of the strategy and vision for product roadmaps; establish collaborative relationships with external and internal stakeholders, gather accurate state and contractual requirements, and evaluate product performance for enhancements. You will join an elite team to lead large projects and influence leadership successfully to adapt and embrace change, helping to heal the health care system and bring services to our Medicaid Members.
On a day to day basis, you will oversee all behavioral health clinical management activities within the MCO and take an active role consulting with the MCO on clinical and policy decisions. You will also consult with Medical Directors, Behavioral Clinicians and Providers who are working directly with members who have significant Mental Health and Substance Use issues to ensure the program is meeting objectives.
- Ensure that the MCO’s behavioral health clinical operations are in compliance with the state contract
- Provide clinical consultations and guidance for contracted providers including PCPs who treat behavioral health-related concerns not requiring referral to behavioral health specialists
- Participate in developing comprehensive person centered care plans and identifying placement and treatment needs for individuals with complex medical and behavioral health conditions (Behavioral Health point person)
- Take part in new provider orientation and in delivering targeted education and training for network providers
- Actively engage in behavioral health and integrated health clinical rounds for members with complex conditions
- Use utilization management, care management, quality and other data sources to identify areas of opportunity for implementing clinical initiatives to improve outcomes for Medicaid members
- Ensure the MCO operates with a recovery based philosophy by working with Recovery and Resiliency team members, modeling behaviors aligned with the Principals of Care and delivering training, as needed, to address social determinants of health and understanding levels of care
- Promote and validate systematic internal and external screening practices for BH-related disorders in line with contract requirements
- Promote, identify and develop opportunities to implement preventative BH strategies that support diversion from more restrictive levels of care
- Anticipate customer needs for product enhancements / improvements that grow our Medicaid business and proactively develop solutions to meet these needs
- Provides subject matter expertise in areas including product development, clinical design, program specifications, and staffing projections
- Think strategically and creatively, about the consumer and provider within the Optum Product experience, translating a vision to processes and requirements
- Identify gaps relative to clinical performance, identifying partnership opportunities and performance improvement action plans
- Manage ongoing customer relationships and service delivery for an assigned area/state
- Navigate and influence multiple cross - functional teams in a complex, matrix work environment, including influencing senior leadership to adopt new ideas, products, and / or approaches
- Partner closely with the Operational Directors on providing context and support for state and customer meetings
- Must be a currently practicing behavioral health clinician (LCSW, LPC, LMFT, PhD); or RN with a Bachelor’s degree with 5 years behavioral health experience
- Must have an unrestricted license in the State of Tennessee
- Minimum of 5 years of combined clinical experience in mental health and substance use disorder services
- Experience working with community-based programs that assist the TennCare population
- Strong data analysis and organizational skills
- Proficiency in Microsoft Office applications
- Experience with primary care/behavioral health integration
- Experience with managed care
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