Product Director, Behavioral Product Management - Medicaid - Baton Rouge, LA

Do you love the excitement of a fast-paced, high-growth organization? If so, a career at Optum, part of the UnitedHealth Group family of businesses will allow you to serve almost all dimensions of the health system; from those who diagnose and treat patients to those who pay for care, deliver health services and those who supply the cures. Optum 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. Join us and learn why there is no better place to do your life's best work.(sm)
 
Our Product Development and Management groups are vital to our success and are leaders in driving the future growth of UnitedHealth Group. Success in these careers relies on many factors - ability to deal with ambiguity, your ability to adapt and embrace change, and a long-term commitment to making health care better for everyone. The Population Health Solutions Group within Optum is seeking a self-motivated, solution-oriented Behavioral Health Associate Population Health Director to grow our Medicaid Clinical Services business.
 
As the Behavioral Health Associate Population Health Director, you will be vital to our success and drive the future growth. You will be accountable for the performance of the Behavioral Health component of the Whole Person Care program in Louisiana. You will participate in the development of the strategy and vision for product roadmaps; establish collaborative relationships with external and internal stakeholders, gather accurate state and contractual requirements, and evaluate product performance for enhancements. You will join an elite team to lead large projects and influence leadership successfully to adapt and embrace change, helping to heal the health care system and bring services to our Medicaid Members.
 
On a day to day basis, you will oversee all behavioral health care management activities within the MCO and take an active role consulting with the MCO on clinical and policy decisions.  You will also consult with Field Based Community Health workers, Behavioral Clinicians and Providers who are working directly with members who have significant Mental Health and Substance Abuse issues to ensure the program is meeting objectives.
 
The scope of the position leverages in-depth quantitative skills and knowledge of the Medicaid market.
 
Primary Responsibilities:

Product Development, Sales Solutioning and Support:

Anticipates customer needs for product enhancements / improvements that grow our Medicaid business and proactively develops solutions to meet them
Provides subject matter expertise in areas including product development, clinical design, program specifications, and staffing projections
Work closely with Business Sales to supports development of RFP / RFI responses for Medicaid, be aware of and maintain the opportunity pipeline alert to potential areas for growth and when to engage cross functional clinical partners
Think strategically and creatively, about the consumer within the Optum Product experience, translating a vision to processes and requirements
Program Performance & Improvement:

Monitor and oversee local market performance, including affordability and cost trends for designated health plans
Identify gaps relative to clinical performance, identifying partnership opportunities and performance improvement action plans
Accountable for understanding and documenting state RFP commitments, contractual requirements, addendums, policy changes and ensure Optum meets or exceeds those requirements through the Whole Person Care Model clinical model
Identify and analyze local market trends, service gaps and the development of mitigation strategies aligned with our strategic priorities
Proactively identify savings opportunities and drive operational changes in support of process improvements, cost savings & clinical initiatives
Using utilization management, care management, quality and other data sources to identify areas of opportunity for implementing population health improvement initiatives for Medicaid members
Care Management:

Design, develop and refine the Care Management strategy impacting how we integrate medical and behavioral care management and care provided
Assist in creating industry leading programs to address the chronic needs of members facing co-morbid medical and behavioral health issues
Develop strategies to help members throughout their lives reach their optimal physical and behavioral health needs
Ensure the MCO operates with a recovery based philosophy by working with Recovery and Resiliency team members, modeling behaviors aligned with the Principals of Care and training all staff on practical application of these principles with a focus on: care management, service coordination to address social determinants of health and understanding levels of care
Promotes, identifies and develops opportunities to implement preventative BH strategies that support diversion from more restrictive levels of care
Lead / and / or participate in local / national clinical projects that result in the development or improvement of local clinical services and / or access to care
Relationship Management:

Manages ongoing customer relationships and service delivery in Louisiana
Navigate and influence multiple cross-functional teams in a complex, matrix work environment, including influencing senior leadership to adopt new ideas, products, and / or approaches
Partner closely with the Operational Directors on providing context and support for state meetings
Collaborate with Clinical Operations for any market required clinical processes. (i.e. development of job aids, QRGs)
Work closely with Optum’s Relationship Office, Business Sales Development, Finance, Marketing, Product, Work Force Management and Operations teams to formulate improvement strategies across the Medicaid business and monitor all investment levers
Translate highly complex concepts in ways that can be understood by a variety of audiences
Routine interface with BH Network to ensure access to care meets the needs of the membership
Routine interface with the Optum Relationship Office to ensure contractual obligations and market expectations are being met
Compliance:

Act as the primary BH clinical source for the Customer, State and other Stakeholders to address routine and complex member issues / concerns.  As required by Contract, be a physical presence in the community with community providers, state agencies, advocacy agencies / groups
Ensuring that the MCO’s behavioral health care management operations are in compliance with the state contract
Promotes and validates systematic internal and external screening practices for BH-related disorders in line with contract requirements
As required by Contract, conduct / attend Adhoc trainings with provider community as requested
As required by Contract, lead / and / or participate in provider forums as needed
 

Required Qualifications:

Bachelor Degree
5+ years of leadership and administrative experience in public sector or Behavioral Health care
Possesses an active, independent, and unrestricted behavioral health licensure and certification from the state or board which issued the credentials
Thorough understanding of managed care principles, models and financing required with a minimum of 3 years of experience working in a corporate managed health care environment
5+ years of product management / product development or health care experience
Prior experience in public sector mental health or non-profit community mental health, with knowledge of Medicaid populations
Strong data analysis and PC proficiency
Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
Demonstrated ability to achieve goals in a matrix environment
Demonstrated ability to work collaboratively and influence others
Proficient in interpreting and analyzing data to support decision making
Excellent Microsoft Office skills, including advanced Excel, Power Point Skills and Word skills
Demonstrated ability to prioritize projects and deliverables
Experience with reading and responding to an RFP
Ability to quickly understand and make decisions when information is limited
Willingness to proactively seek and find contacts to pull together facts
Ability to travel, 10%
Knowledgeable about primary care/behavioral health integration
Preferred Qualifications:

Advanced Degree
Experience in a recovery-oriented delivery system greatly preferred
Licensed addiction counselor (LAC) or LMHP with at least seven (7) years of clinical experience with addiction treatment of adults and children experiencing substance use problems and disorders
Strong background and / or understanding of the healthcare industry, operations, case management experience
Population health experience
Experience with special Medicaid populations, including LTSS, ABD, SMI, DD, Foster Care
Demonstrated excellent verbal and written communication skills
Prior experience making oral presentations
Strong customer service orientation
Product development, product management, operational or financial strategy development experience within a matrix organization
Project (program / product) management experience
Experience with effectively presenting to Senior Management
Ability to think and act strategically, and as well as execute tactically with bias toward action
Ability to manage projects simultaneously and achieve goals
Excellent follow through, attention to detail, and time management skills
Strong interpersonal skills; brings an ability to work collaboratively with a wide range of individuals at all levels of the organization
Exceptional planning, organization and monitoring skills
Excellent interpersonal and problem-solving skills
Strong team player and team building skills
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: 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.
 
 
Job Keywords: Product Director, Behavioral Product Management - Medicaid, Product Management, Product Development, Baton Rouge, LA, Louisiana
 
Â