Clinical Operations Director- Philadelphia, PA - Full-time / Part-time

For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.

OptumHealth Behavioral Solutions is driven by powerful and propriety clinical management methods that optimize the health and well-being of individuals. All Behavioral Solutions programs incorporate state-of-the-art predictive modeling, outcomes management and evidence-based best practices. The result is better care and a reduction in overall health care costs.

We are looking for a Clinical Operations Director to join our dynamic team in Philadelphia, Pennsylvania.

The Clinical Operations Director has overall responsibility for the delivery of quality clinical services including effective, care management, account management, claims customer service, medical and QI functions of the mental health care program. Responsible for maintaining strong, effective clinical and ethical standards, protocols, and procedures and to do so while managing service utilization and other business metrics to expected targets.

Responsibilities:

• Provides management, supervision and strategic direction for the behavioral health care program. Responsible for overall quality and P&L results.


• Responsible for meeting clinical and ethical standards and protocols as well as implementing procedures to support them.


• Plans, implements and monitors operational systems for the program. Chairs and participates in committees and workgroups involving program staff and other stakeholders as required.


• Sets and monitors departmental quality and performance standards (as required by federal/state, JCAHO, URAC, or similar accrediting bodies) for clinical and administrative functions of staff; does so in conjunction with the RVP and representative. Represents the mental health care program in all OptumHealth Behavioral Solutions QI activities.


• Responsible for budget planning, adherence and forecasting as required.


• Monitors and manages activity to meet utilization expectations and participates in the development and analysis of outcome data and the response to those data. Continuously applies data to improve operational efficiency, outcomes, member and client satisfaction.


• Oversees hiring, orientation, training, recognition programs, disciplinary actions, staff development, staff retention and performance evaluations.


• Supports the account management/sales function for the PHL CAC.


• Coordinates and participates in the sales, marketing, and implementation of new products, programs, services on behalf of the PHL CAC.


• Participates with other directors and managers within the region to implement strategic initiatives, policies and procedures.


• Participates in the identification and implementation of best practices.


• Other duties as assigned by the RVP.
  

Requirements:

• Licensed Psychologist, LSW, RN or LPC in behavioral healthcare discipline required.


• Masters degree in business administration a plus.


• At least 4-7 years of experience in behavioral managed care environment.


• Experience in a broad range of settings with a proven track record of attaining positive quality and financial results.


• Strong clinical background and skills required in behavioral managed care, including demonstrated success in establishing effective clinical protocols as well as achieving both performance and quality standards and goals.


• Experience must include significant management responsibilities at the director level including P&L, hiring and effective performance management.


• Demonstrated success in matrix-management organization a plus.


• Background in insurance/HMO strongly desired.


• Demonstrated team-building and overall leadership ability.


• Skilled in managing and motivating employees in a call center/clinical environment a plus.


• Demonstrated skill in the use of computers, Microsoft Office, email systems, as well as in overall written communication.


• Experienced in supporting accreditation efforts (e.g. JCAHO/NCQA) and meeting regulatory/compliance standards.


• Strong customer service orientation.


• Ability to effectively manage employees and influence others outside of direct reporting relationship in the achievement of goals and objectives.


• Strong interpersonal and presentation/platform skills plus expertise in communicating the business units capability and results to prospective, as well as existing customers.


• Experience in creative, innovative and solution-focused problem-solving, as well as managing workflow and systems development and maintenance.


• Must be a team player, flexible, highly ethical, value-driven, results-oriented and a professional of high personal integrity.

Keywords: Operations, Utilization Management, Account Management, Clinical.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth 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.