Job Description

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry thats improving the lives of millions. Here, innovation isnt about another gadget, its about making health care data available wherever and whenever people need it, safely and reliably. Theres no room for error. Join us and start doing your lifes best work.(sm)

You are a thought leader who thrives on developing new solutions to solve tough challenges. As a critical leader of our Behavioral Health Clinical Operations team, you will help rewrite the future of Optum. Here, your analytical and innovative skills will help us with our mission of helping people live healthier lives. Yes, we share a mission that inspires. And we need your organizational talents and business discipline to help fuel that mission.
As a Associate Vice President of Clinical Operations for Southwest reporting directly to the Vice President of Clinical Operations, overseeing utilization management and care advocacy programs, you will be empowered to support and develop short and long term operational/strategic business activities develop, enhance and maintain operational information and models that will have an impact on business decisions. In this leadership role, you will have the opportunity to set the teams direction, resolve problems and provides guidance to members of various teams throughout the enterprise. Your decisions and contributions will impact multiple groups of employees and/or customers (internal and/or external).
The ideal candidate will have experience in implementations, product design, analytics, business management, and the ability to drive change at all levels of the organization. The Associate Vice President overseeing these regions must be able to draw upon a matrixed team to drive complex business processes throughout and across the organization and will be accountable to affordability targets and contractual business requirements. This includes developing and implementing rigorous behavioral health utilization management and care advocacy models that maximizes member and provider engagement, optimizes behavioral health outcomes, and controls behavioral health trend for benefit management. This individual leverages data, and partners with Enterprise leaders and internal and external vendors to drive a unit that supports the appropriate utilization of the highest quality behavioral health settings in the most appropriate settings. We are looking for a candidate that has a diverse longevity of experience working within a managed care setting across all lines of business and is very familiar with behavioral health utilization management and care management / care engagement strategies. Additionally, the ideal candidate has experience delivering healthcare services in a variety of community-based settings and facility-based settings.
Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
* Serves as a behavioral health leader in key decision meetings
* Provides a leadership shadow to over 300 employees
* Responsible for oversight behavioral health utilization management and care advocacy programs in the Southeast
* Monitoring of staff productivity and development of &ldquobest practices&rdquo to meet stakeholder expectations and key performance indicators
* Create and maintain standard operating procedures
* Participate and provide input into executive level decisions
* Day to day oversight and management of behavioral health care coordination, utilization review, behavioral health integration, and consultation services.
* Assist the organization with understanding behavioral health services, populations, state and federal requirements, and ways to improve care.
* Evaluates care delivery model and makes recommendations for program development as well as program sunsets based on changing population needs, effectiveness, benefits, the member experience, and return on investment
* Manages resources where they are appropriately allocated to programs responsible for the operational controls that exist, and assures efficiencies are maximized
* Works collaboratively with other departments to maximize HEDIS, CAHPS, and STARs ratings which integrate behavioral health services. Ensures behavioral health services have metrics, meet regulatory reporting requirements, and remain in compliance with accrediting bodies
* Actively participates in and takes ownership of meeting value optimization strategies
* Demonstrate understanding of process improvement methodology and completes projects within appropriate timeframe as directed by leadership
* Performs root cause analysis and coordinates activities to enhance the clinical outcomes of the population
* Makes decisions for operations that are guided by clinical insights, strategy, alignment of priorities, policies, procedures, and business plans
* Assists with developing workflows required to meet customer needs or partners with policy writers to review
* Resolves problems and provides guidance to clinical operations staff

Youll 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
* Clinical License (Mental Health and/or RN)
* 5 years of experience in managed care
* 5 years progressive, high impact, management experience
* Have held a substantial leadership position in a managed care company, public program or organization serving government entities
* Have significant experience leading, developing and launching new behavioral health model and utilization management initiatives for multiple lines of business
* Appreciation for the individuals served by the behavioral health system of care
* Ability to successfully work in a matrix management environment, with a proven track record of building and maintaining effective internal partnerships that lead to external client satisfaction
* Exceptional relationship skills, with proven ability to quickly build and maintain strong relationships across diverse functions and leaders including market leaders, health plan CEOs and CMOs
* Strong strategic thinking and business acumen with the ability to align strategies and recommendations with clinical operations objectives. Adaptable and flexible style of collaborating with key stakeholders in setting direction
* Proven ability to quickly gain credibility, influence and partner with business leaders and the clinical operations community
* Strong attention to detail, particularly in taking large amounts of data and making decisions based on those details
* Ability to lead and motivate people to achieve agreed-upon results, with a focus on driving disciplined, fact-based decisions and executing with discipline and urgency
* Ability to balance multiple accountabilities and organizational change
* Proficiency with Microsoft Word, Outlook, Teams, SharePoint, PowerPoint, Visio and Excel
* Excellent oral and written communications / interpersonal skills
* Strong presentation skills
* Access to high speed internet from home and a dedicated workspace
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications
* Masters degree in behavioral health field
* Proficiency with MS Teams and SharePoint
* Lean Six Sigma experience
* Experience with population health and medical behavioral health integration
* Experience in Change Management

Careers with Optum. Heres the idea. We built an entire organization around one giant objective make health care work better for everyone. So when it comes to how we use the worlds 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 lifes best work.(sm)

Colorado Residents OnlyThe salary range for Colorado residents is $110,200 to $211,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirementsHealth, dental, and vision plans wellness program flexible spending accounts paid parking or public transportation costs 401(k) retirement plan employee stock purchase plan life insurance, short-term disability insurance, and long-term disability insurance business travel accident insurance Employee Assistance Program PTO and employee-paid critical illness and accident insurance.
* All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy
Diversity creates a healthier atmosphereUnitedHealth 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 KeywordsAssociate Vice President of Clinical Operations, Southeast Regions – Behavioral Health, Managed Care, Management, Clinical, Mental Health, Richmond, VA, Virginia, Raleigh, NC, North Carolina, Charlotte, NC, Greenville, SC, South Carolina, Atlanta, GA, Georgia, Tampa, FL, Florida, Jacksonville, FL, Birmingham, AL, Alabama, Jackson, MI, Michigan, Shreveport, LA, Louisiana, Nashville, TN, Tennessee, Telecommute, Telecommuter, Telecommuting, Remote, Work from home, Work at home

Requisition Number:924228

Business Segment:Enterprise Clinical Services

Employee Status:Regular

Job Level:Director

Travel:Yes, 25 % of the Time
Additional Locations

Birmingham, AL, US
Jacksonville, FL, US
Tampa, FL, US
Atlanta, GA, US
Shreveport, LA, US
Jackson, MI, US
Raleigh, NC, US
Charlotte, NC, US
Greenville, SC, US
Nashville, TN, US

Overtime Status:Exempt

Schedule:Full-time

Shift:Day Job

Telecommuter Position:Yes