Company

OptumSee more

addressAddressBaton Rouge, LA
type Form of workFull-time
salary Salary$137K - $174K a year
CategoryManufacturing

Job description

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.


The Behavioral Health Clinical Director is responsible for providing leadership and subject matter expertise related to Behavioral Health disorders for all members covered by the Integrated Managed Care contract in LA. This role will work closely with the clinical leadership within the health plan, state partner agencies and matrix partners within Optum to ensure contract requirements are met and ensure members needs are addressed. This position will report to the LA BH Executive Director and will be key to developing/maintaining a system that meets the needs of the membership.

If you are located in Louisiana, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Responsible for ensuring contractual requirements related to the clinical system care are met
  • Attend local and state meetings related to administration of Behavioral Health services
  • Act in the capacity of a Subject Matter Expert (SME) for the administration of Behavioral Health services
  • Coordinate with all allied Behavioral Health systems
  • Analyze trends and provide leadership to address system gaps or other system needs/issues
  • Identify and examine system gaps and other determinants of readmission to higher levels of care facilities
  • Support outcome-focused, evidenced-based best practices and guidelines with providers
  • Establish and maintain professional working relations with referral sources, community resources, and care providers and be able to identify and communicate network gaps to appropriate resources
  • Understand benefits in compliance with plan inclusions, limitations, and State/Federal mandates
  • Represent United Healthcare Community Plan in various administrative meetings with state officials and other entities involved in the provision and monitoring of services
  • Maintains knowledge of current legislation and State and Federal administrative codes
  • Oversee contractual and policy changes as they relate to Behavioral Health in LA

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:

  • Master's degree OR 7+ years of experience in managed care
  • Proficiency with Microsoft Office Suite programs (Word, Outlook, Internet)
  • Demonstrated competence in clinical care management, strong leadership and organization skills; interpretation of State and federal laws and regulations relevant to the Behavioral Health program area
  • Knowledge of evidence-based, best, and promising practice methods and procedures and strong customer service orientation
  • Excellent verbal, written, and interpersonal communication skills
  • Reliable transportation with the ability to accommodate some field-based travel within the service delivery area


Preferred Qualifications:

  • 3+ years of experience working within LA leadership roles
  • Experience administering/implementing Medicaid program
  • Dual diagnosis experience with mental health and substance abuse and developmental disabilities
  • Experience working in a Managed Care Organization (MCO)
  • Demonstrated familiarity and experience with the current Diagnostic and Statistical Manual and best practice standards for treatment
  • Familiarity with the Behavioral Health services in LA
  • Familiarity of publicly funded healthcare and social service systems and Medicaid eligible or enrolled populations
  • Familiarity with recovery and resiliency model
  • All Telecommuters 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.

Refer code: 8885296. Optum - The previous day - 2024-04-05 03:30

Optum

Baton Rouge, LA
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