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UnitedHealth Group Clinical Program Manager, Case Management - Remote in Upstate NY in Syracuse, New York

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Clinical Program Manager has responsibility for oversight of state-contracted Case Management operations for an Under 21 Behavioral Health population including management of staff, compliance with audits, management of state-based initiatives, adherence to NCQA / HEDIS measures, and all administrative services to assure the ongoing work of Optum Case Management New York.

If you live in Upstate New York , you will have the flexibility to work remotely* as you take on some tough challenges. Residency in in Upstate New York is required.

Primary Responsibilities:

  • Manages and is accountable for management and supervision of Behavioral Health Care Managers in field/facility-based roles

  • Sets team direction, resolves clinical problems, and provides guidance to members of own team

  • Monitors, manages, and controls operational and performance metrics in conjunction with established program value targets

  • Adapts departmental plans and priorities to address business and operational challenges

  • Influences or provides input to forecasting and planning activities

  • Develops solutions to address new and often complex customer requirements that address operational, clinical, and customer needs

  • Ensures audits are conducted, standards are met, and successful outcome are achieved

  • Reviews operational and performance metrics regularly and drives action plan development and execution

  • Ensures site remains compliant with all applicable regulatory and accreditation requirements (NCQA, URAC, and New York State regulations)

  • Collaborates across OCHS and UHG including medical, site directors, senior leaders, sales, account management, product organization, and other stakeholders

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:

  • Active, unrestricted, independent behavioral health licensure in the State of New York, able to supervise lesser licensure: LCSW, LMHC, LMFT, or LP

  • 5+ years of High-Risk Behavioral Health Case Management experience with the Under 21 population

  • 3+ years of supervisory or management experience, including performance management functions (i.e., hiring, performance evaluations, corrective action plans, etc.)

  • 1+ years of experience working with adult populations

  • Highly proficient in Microsoft Word, Excel, and PowerPoint

  • Access to install secure, high-speed internet and a dedicated workspace at home

  • Reside in Upstate New York

Preferred Qualifications:

  • 5+ years of post-licensure diversified experience: psychiatric, chemical dependency, or outpatient therapy, with an emphasis in differential diagnosis

  • 1+ years of HARP experience

  • Experience in a field-based position

  • Experience working at an MCO or with the Medicaid population

  • Experience in a position serving members with complex trauma

  • Experience working for an insurance company or other managed care setting

  • Experience with accreditation requirements (NCQA, URAC, and New York State regulations)

  • Demonstrated ability to develop strategic plans, attainable goals, drive performance, and achieve targets

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

New York Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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: 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.

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