Associate Director Behavioral Utilization Management - Remote

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 Associate Director, Behavioral Utilization Management is responsible for the review of behavioral health and substance abuse services for the newly formed dedicated book of business. This includes authorization, concurrent review, coordination and assurance of appropriate levels of care to members. Provides benefit management services through review and evaluation of inpatient and outpatient behavioral health treatments for medical necessity, emergency status, and quality of care. This is a new role for a book of business that will require ongoing implementation and monitoring of program progress.

If you are located in Michigan, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Provides leadership to and is accountable for the performance of managers and/or senior level professional staff
• Drives overall financial outcomes including appropriate oversight and influence of benefit expense; ensures that care delivered is efficient and appropriate for the unique circumstances of members
• Leads Operational strategy through our Business Action plans in coordination with our MD, Product and Value Optimization partners
• Develops and executes processes that support improved Medical-Behavioral Integration with partners. Including the development of close working relationships with partners within the medical delivery environment including external providers
• Develops and maintains a budget process including annual financial & operational performance objectives
• People Leadership
  • Provide direct oversight to a utilization management team, for employees at multiple locations across the country (remote)
  • Ensure that department goals are communicated clearly, and that goals are met or exceeded through team efforts
  • Lead within a matrix organization by building and sustaining relationships with internal and external business partners to lead programs, define timelines, resolve issues and guide ongoing improvements
  • Provides leadership to and is accountable for the performance of managers and/or senior level professional staff
• Ensure that department goals are communicated clearly, and that goals are met or exceeded through team efforts
• Monitors to ensure that all client, state, national and accreditation organizations regulatory guidelines are maintained through a rigorous audit process in collaboration with partners
• Lead within a matrix organization by building and sustaining relationships with internal and external business partners to lead programs, define timelines, resolve issues and guide ongoing improvements
• Provide direct oversight to a utilization management team, for employees at multiple locations across the country (remote)
• Viewed as a credible business leader and inspires staff - facilitates a shared vision and urgency for changes by clarifying how the change will help the organization meet business goals and by articulating the benefits of change
• Uses data to identify trends, patterns, issues and opportunities that have an impact on the business and utilizes the data to help make sound business decisions/recommendations

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:

• Proven excellent communication, collaboration, team building and relationship management skills
• Licensed, Master's degree level in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., or an RN with 2+ years of experience in behavioral health
• Clinical Licensure must be active, current, and unrestricted
• Demonstrated experience with building/rebuilding a “team” or part of a turn around that required to not only participate in all day-to-day managerial tasks (mentoring, auditing, training, etc.) but also able to demonstrate the need to build a culture of service
• Experience interfacing with providers and solutioning gaps
• 5+ years of experience managing a clinical/operational unit in a broad range of settings
• 3+ years of people management experience (managing direct reports, coaching, training, performance reviews, running team meetings, etc.)
• Successful in obtaining results in a large corporate, matrixed environment and collaborate with cross functional teams
• Proven capability of gaining support for initiatives through influence and use of business rationale
• Proven ability to make and implement tough decisions

Preferred Qualifications:

• Solid proficiency with navigating in a Windows based environment and within MS Office applications
• Proven ability to manage members with complex medical, family and social relations (Exchange DSNP, Duals, Medicaid)

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.

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.