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Behavioral Health Facility Practice Specialist - Nationwide Availability
| Hours | Full-time, Part-time |
|---|---|
| Location | Portland, OR Portland, Oregon |
About this job
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm)
Primary Responsibilities will include:
- Interface with senior leaders (e.g., CEO) at high volume facilities/groups.
- Communicate with facilities/groups to initiate appropriate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with care advocacy processes and contractual obligations
- Support those high performing facilities such that performance remains at a high level.
- Identify facility outliers through analysis of clinical outcomes data, utilization/claims data, complaints, and compliance with care advocacy protocols.
- Measure improvement of program performance over time.
- Monitor and report effectiveness of interventions.
- Modify interventions as appropriate.
- Initiate and monitor Corrective Action Plans (CAPs) as appropriate to affect performance.
- Interface with other OHBS departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement.
This could be telecommute position depending on location
Requirements
Required Qualifications:
- Licensed Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling OR a Licensed Ph.D. level Psychologist OR psychiatric nurse
- Licenses must be active and unrestricted in your state of residence
- Minimum of three years of Managed Care and/or Utilization Review experience in a Managed Care setting
- Prior experience with CPT/HCPCS codes
- Strong analytical skills with knowledge of or willingness to learn analytics software such as Microsoft Excel
- Strong computer proficiency with Word, Outlook, and Internet
Preferred Qualifications:
- Minimum three years (POST- LICENSURE) direct clinical experience
- Knowledge of the public sector, i.e., Medicaid
- Strong communication skills, written and verbal
- Ability to balance contractual and clinical considerations
- Ability to work in a self-directed manner, seeking guidance on only the most complex tasks
- Capacity to provide solutions for non-standard and/or complex issues solutions
- Excellent time management and prioritization skills
- Ability to establish and maintain strategic relationships with facilities senior leadership teams
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.
Job Keywords: Social Work, Counseling, Analytics software, Portland, OR, Oregon, Atlanta, GA, Georgia, Chicago, IL Illinois, Minneapolis, MN, Minnesota, Houston, TX, Texas