Behavioral Health Clinical Director - Omaha, NE(Job Number:700505)
Our Product Development and Management groups are vital to our success and are leaders in driving the future growth of Optum. Success in these careers relies on many factors - ability to deal with ambiguity, your ability to adapt and embrace change, and a long-term commitment to making health care better for everyone. The Consumer Solutions Group within Optum is seeking a Behavioral Health Clinical Director.
As the Behavioral Health Clinical Director, you will be vital to our success and drive future growth. You will be accountable for the performance of the Behavioral Health component of the Whole Person Care program in an assigned area. You will participate in the development of the strategy and vision for product roadmaps; establish collaborative relationships with external and internal stakeholders, gather accurate state and contractual requirements, and evaluate product performance for enhancements. You will join an elite team to lead large projects and influence leadership successfully to adapt and embrace change, helping to heal the health care system and bring services to our Medicaid Members.
On a day to day basis, you will oversee all behavioral health care management activities within the MCO and take an active role consulting with the MCO on clinical and policy decisions. You will also consult with Field Based Community Health workers, Behavioral Clinicians and Providers who are working directly with members who have significant Mental Health and Substance Abuse issues to ensure the program is meeting objectives.
- Ensuring that the MCO’s behavioral health care management operations are in compliance with the state contract
- Providing clinical case management consultations and clinical guidance for contracted PCPs treating behavioral health-related concerns not requiring referral to behavioral health specialists
- Participate in developing comprehensive care management programs for youth and adults with behavioral health concerns, typically treated by PCPs, such as ADHD and depression
- Developing targeted education and training for the MCO’s PCPs that commonly encounter behavioral health issues
- Leading/Participating in behavioral health and integrated health clinical rounds for members actively engaged in care management
- Using utilization management, care management, quality and other data sources to identify areas of opportunity for implementing population health improvement initiatives for Medicaid members
- Ensuring the MCO operates with a recovery based philosophy by working with Recovery and Resiliency team members, modeling behaviors aligned with the Principals of Care and training all staff on practical application of these principles with a focus on: care management, service coordination to address social determinants of health and understanding levels of care
- Promotes and validates systematic internal and external screening practices for BH-related disorders in line with contract requirements
- Promotes, identifies and develops opportunities to implement preventative BH strategies that support diversion from more restrictive levels of care
- Anticipate customer needs for product enhancements / improvements that grow our Medicaid business and proactively develops solutions to meet them
- Provides subject matter expertise in areas including product development, clinical design, program specifications, and staffing projections
- Think strategically and creatively, about the consumer within the Optum Product experience, translating a vision to processes and requirements
- Identify gaps relative to clinical performance, identifying partnership opportunities and performance improvement action plans
- Manages ongoing customer relationships and service delivery for an assigned area
- Navigate and influence multiple cross - functional teams in a complex, matrix work environment, including influencing senior leadership to adopt new ideas, products, and / or approaches
- Partner closely with the Operational Directors on providing context and support for state meetings
Primary Location US-NE-Omaha
Organization Medicaid Clinical Solutions
Number of Openings 1