Description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

To apply clinical and behavioral health knowledge and work in collaboration for all enrollees identified as eligible to receive Arizona Long Term Care System (ALTCS) services in which behavioral health services are integrated with clinical and social supportive services, as a model of care to ensure enrollee needs are met in the most cost-effective manner. Provide support across the LTC case management program and ensure the overall LTC Behavioral Health contractual adherence through monitoring, auditing, and training occur. The Director of Case Management/Behavioral Health Coordinator is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). This includes case management, coordination of care, problem-solving at the member, family, and provider level and medical/behavioral health management consulting. Function may also be responsible for providing health education, coaching, review/approval of service plans and leading projects.

Hybrid position which will require Phoenix office-based duties, remote work and about 25% travel in the regions served.

This position follows a hybrid schedule with two to three in-office days per week based on business needs.

Primary Responsibilities:

• Excellent Communication skills and ability to interrelate with individuals at various levels and in various functional areas throughout the organization and to develop effective business relationships
• Working collaboratively with providers, as well as with internal plan management and Medical Directors in setting direction and strategic planning to develop, implement and monitor action plans to modify care delivery patterns and reduce expenses
• Monitor the Court Ordered Treatment process to ensure accurate and timeliness occurs with legal and clinical requirements
• Monitor the Child and Family Team (CFT) facilitation of quarterly Clinical Connection meetings for licensed LTC staff, promote collaboration and best practices
• Supervise the LTC Coordinator for the Office of Human Rights, monitoring portal compliance and Case Manager integration of the person providing Special Assistance's integration into care planning
• Oversee transitions from the Regional Behavioral Health Authority (RBHA) into Long Term Care services for members with an SMI designation
• Develops annual goals and objectives to achieve appropriate reductions in medical expenses that correlate with continuous performance and quality of care improvement efforts
• Provide training to new and existing Case Management staff and providers about behavioral health services, programs and processes
• Oversee the High Risk Behavioral Health case management managerial staff and Behavioral Health Professionals
• Serves as a mentor, monitors adherence to state contract requirements and performance measure outcomes
• Serves as the key Behavioral Health Services/Case Management resource and consultant to internal and external customers. Form strategic relationships which will support program growth, expansion and the development of new models/programs
• Lead and support our LTC case management department staff and Health Plan membership. Ensure overall LTC
• Behavioral Health Medicaid contractual adherence through monitoring, auditing, reporting and training
• Creates a team oriented management environment, enhancing the integration between behavioral, clinical and operations sections of medical affairs
• Review program descriptions and consultation with potential providers joining the network. Complete provider visits to review additional contract requirements for placements with integrated behavioral supports
• Review the Behavioral Health Network to reduce out of state placements and/or actively stay involved in any out of state placement for behavioral health services
• Develops clear goals and objectives for performance management and effectively communicates accountability
• Ensures standardized execution of workflow processes, such as authorizations, adherence to documentation requirements and analyzing outcomes of standardized audits for AHCCCS, HSAG, NCQA and HEIDIS purposes
• Responsible for department policies and procedures, training of LTC Case Management staff and external providers, and day-to-day support clinical support, including Behavior Health and substance use consultations
• Act as the Liaison for children in Department of Child Safety (DCS) custody

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:

• Current, unrestricted Licensed Behavioral Health Professional in Arizona
• 5+ years serving individuals who are elderly and/or individuals with physical or developmental disabilities and with an SED or SMI designation
• 5+ years of management experience
• Supervisory and training experience
• Basic knowledge of ALTCS/ Medicare / Medicaid regulations
• Working knowledge of Microsoft Word, Excel, and PowerPoint
• Computer efficiency
• Located in Maricopa County, Arizona
• Ability to work a Hybrid schedule which includes 2-3 days in the Phoenix office based on business needs
• Ability to travel up to 25% of the time in assigned regions in Arizona
• Driver's License and access to reliable transportation

Preferred Qualification:

• Behavioral Health experience
• Long-term care experience
• Home Health experience
• Managed Care experience
• Care Coordination experience
• Proven solid written / grammar and communication skills, excellent time management skills, the ability to master new skills and ideas, able to adapt to change, and exhibit flexibility
• Proven ability to function independently and responsibly with minimal need for supervision
• Proven flexible and able to meet short timelines
• Demonstrate initiative in achieving individual, team, and organizational goals and objectives

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.