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UnitedHealth Group Utilization Management Process Manager - Remote in Seattle, Washington

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 that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

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 supports business in Alaska, includes up to 25% travel, and requires working Pacific Time Zone hours.

You will have the flexibility to work remotely* from anywhere in the US as you take on some tough challenges. Due to business requirements, candidates in the Western US / Pacific Time Zone are 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 coordination 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 client, 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

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 in behavioral health or Doctorate-degreed Psychologist

  • Active, unrestricted, independent clinical behavioral health license

  • 3+ years of public sector or non-profit community mental health administration / management experience with knowledge of Medicaid populations

  • Project management experience

  • Demonstrated understanding of managed care principles, models, and financing

  • Solid data analysis and PC proficiency

  • Access to high-speed internet via cable/DSL/Fiber and a dedicated, distraction-free workspace at home

  • Ability to travel up to 25% regionally

  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

  • Experience in a recovery-oriented delivery system

  • Administrative experience in the Alaska mental health and substance abuse service delivery system and in administering a similar contract

  • Account management experience

  • Excellent verbal and written communication skills

  • Exceptional planning, organization, and monitoring skills

  • Solid customer service orientation

  • Demonstrated 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

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Here's 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 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)

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

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.