Director, Clinical Operations, Behavioral Health Care Advocacy, Chicago Job in Schaumburg 60173, Illinois US
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans.
Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling.By providing 58 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their health care needs, and enabling them to achieve their personal health and well-being goals.
The Director has primary responsibility for clinical deliverables for the Public Sector team at the CAC level and supervises Clinical Program Managers.
This includes implementation of new projects and new business, budget adherence, development and adherence to clinical policies and procedures and establishing priorities based on UBH deliverables.
Also responsible for clinical program planning functions with internal stakeholders and for meeting identified QI business objectives such as accreditation.
Main contact for account implementation and customer complaints.
1. Provide strategic oversight new business implementatio
2. Oversee and document CAC level HCQAI
3. Reporting preparations for Clinical operations and Quality Improvement activitie
4. Analyze data to identify trends in workflow, utilization and staffing and make improvements.
5. Co-chair Clinical Utilization Analyses Committe
6. Resolve escalated issues in a professional and timely manner.
7. Partner with Account Management and Sales departments to provide best level of service to accounts
8. Support sales process by participating in presentations, RFP development, site visits and other customer-related activities.
9. Identify opportunities to sell new services to existing clients, including modifications to benefit structure.
10. Oversee Pilot project
11. Work in concert with Clinical Network services to help identify and fill gaps in the network.
12. Other duties as assigned by Regional Vice President including committees, in-service opportunities and support of other departments, PS CAC sites and CNS partners.
At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system.
You will leverage your skills across a diverse and multi-faceted business.
And you will make contributions that will have an impact that's greater than you've ever imagined.
Registered Masters level psychiatric nurse; licensed masters level mental health professional or licensed PhD License must be unrestricted.
Minimum five years' variable clinical experience in a direct services setting.
Acute psychiatric, chemical dependency and outpatient solution focused therapy experience with an emphasis in differential diagnosis.
Minimum two years' combined experience in health management/administration and clinical supervision required.
PC proficiency, data analysis and strong organizational skills necessary.
Excellent communication, negotiation and customer service skills required.
Managed care and/or insurance experience strongly preferred.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace.
Candidates are required to pass a drug test before beginning employment.
In addition, employees in certain positions are subject to random drug testing.
Additional Information: Travel Percentage: 25%
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