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Practice Management Specialist - Behavioral Health - Tennessee

UnitedHealth Group

Memphis, TN
Job Code:
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Job Details

Practice Management Specialist - Behavioral Health - Tennessee(Job Number:727915)

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 and help people live healthier lives while doing your life’s best work. (sm)
The Behavioral Health Practice Management Specialist must demonstrate strong clinical and analytic skills, strong oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities. They will be responsible for the development of relationships with Community Mental Health Centers (CMHCs), groups, and facilities as well as other outpatient behavioral health group entities. They will monitor their clinical effectiveness and efficiency, as well as compliance with contractual obligations. This Specialist will work closely with Care Advocacy Operations, Affordability and Network Management teams to affect desired outcomes with facilities / programs as it relates primarily to treatment for our public sector membership.    
The Specialist will partner with outpatient facilities / groups that operate outside of typical practice or billing patterns which will be subject to a specific set of interventions.  The Practice Management Specialist’s role with these providers / groups / facilities will be to coordinate a strategic effort that includes Clinical Operations, Network Services, Program and Network Integrity, and Affordability with the goal of designing and delivering interventions aimed at addressing outlier practice patterns, while improving provider performance, quality and clinical outcomes.                 
***Candidates must be permanent Tennessee residents with licensure in the state in order to be considered***
Primary Responsibilities:
  • Interface with senior leaders (e.g., CEO) at high volume facilities / groups
  • Communicate with facilities / groups to initiate appropriate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with care advocacy processes and contractual obligations
  • Support those high performing facilities such that performance remains at a high level
  • Identify facility outliers through analysis of clinical outcomes data, utilization / claims data
  • Measure improvement of program performance over time
  • Measure improvement of program performance over time
  • Modify interventions as appropriate
  • Initiate and monitor Corrective Action Plans (CAPs) as appropriate to affect performance
  • Interface with other Optum departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement

Job Behavioral Clinical Consulting
Primary Location US-TN-Memphis
Other Location 
Organization Optum Ops-PHM Utilization Mgmt
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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