Optum Hiring For Utilization Management Process Manager – Independent BH License – Remote at Anchorage, AK  Full Time

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.

This leadership position is responsible for coordinating the overall behavioral health utilization management (UM) process across a matrixed organization including administration and relationship with the customer as it relates to the UM process. This position will coordinate all key UM clinical functions, acting as a liaison between the various UM teams, and providing UM subject matter expertise (SME), and will administer and deploy business processes and technology-enabled solutions (as available) to deliver benefit to providers and members in the client’s service area.

This position requires working Alaska Time Zone hours, supports business in Alaska, and may include travel to Alaska approximately once or twice per year.

You will have the flexibility to work remotely* from anywhere in the US as you take on some tough challenges. Due to business needs, residency in Alaska is preferred.

Primary Responsibilities:

• Coordinates day-to-day behavioral health UM operations to achieve goals and maintains smooth and efficient functioning to meet the requirements of the client contract
• Aligns and integrates behavioral health programs, including collaboration with care coordination and the various Utilization Management teams (i.e., Facility Based Care, STEM, IOP team, and Autism)
• Coordinates the behavioral health utilization management (UM) teams to ensure effective UM as well as compliance to state specific regulations across all lines of business
• Monitors UM processes and results and identifies any risks related to performance guarantees, UM targets, and quality outcomes; quickly communicates identified risks and recommendations to leadership team
• Monitors and Identifies opportunities to improve UM processes and communicates recommendations to the leadership team
• Interacts closely with the customer, providers, and other internal and external stakeholders to ensure the success of the behavioral health UM program
• Communicates and guides implementation of new contract amendments and requirements as it relates to utilization management.
• Works closely with other account leadership in the effective delivery of services, meeting goals and avoiding all contract penalties
• Formulates action plans to remedy any findings from provider and customer audits, provider concerns or in response to client concerns as it relates to the UM process
• Demonstrates an effective, adaptive leadership style that promotes innovation and accountability and establishes work priorities, and delegates pertinent activities
• Develops reviews and approves documents which provide information and UM program justification; participate in annual program planning and reporting as it relates to the UM process

Required Qualifications:

• Master’s degree in behavioral health or Doctorate-degreed Psychologist
• Active, unrestricted, independent clinical behavioral health license
• 3+ years of experience working at a Managed Care Organization (MCO) including a demonstrated understanding of managed care principles, models, and financing
• 3+ years of public sector or non-profit community mental health administration / management experience with knowledge of Medicaid populations
• Project management experience
• Solid data analysis skills and PC proficiency
• Ability to work a schedule based on Alaska Time Zone hours
• Ability to travel to Alaska approximately once or twice per year
• Access to high-speed internet via cable/DSL/Fiber and a dedicated, distraction-free workspace at home

Preferred Qualifications:

• Experience with Optum’s utilization management processes
• Administrative experience in the Alaska mental health and substance abuse service delivery system and in administering a similar contract
• Experience in a recovery-oriented delivery system
• Account management experience
• Eexcellent verbal and written communication skills
• Exceptional planning, organization, and monitoring skills
• Solid customer service orientation
• Leadership skills including the ability to build effective teams, facilitate staff working together collaboratively, and retain top talent
• Solid report writing capabilities and oral presentation skills
• Residency in Alaska

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York City, or Washington residents is $85,000 to $110,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.