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.
Description
UnitedHealth Military & Veterans Services is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.
We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the South.
Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever. Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions.
It's not just business as usual. It is one of our proudest endeavors.
Purpose of Job:
The Clinical Manager for Behavioral Health Utilization Management is responsible for managing a team of behavioral health UM staff to assure effective, timely and appropriate services are utilized ensure that optimal outcomes for military beneficiaries are achieved. This position will interface closely with Referral Management and Case Management operations to achieve smooth transition of beneficiary services between Case Management and UM and to foster effective channels of communication required to support day-to-day business operations.
The Clinical Manager of Behavioral Health Utilization Management will implement and execute the Utilization Management Program including implementing department infrastructure, systems, policies and procedures, tools and metrics. The Clinical Manager identifies staff development needs by assisting in applying new skills, techniques and understandings to ensure a participative approach to maximize contributions to the department. The Clinical Manager participates in Utilization Management program development and implementation activities required to support consistent Medical Management operations.
This position facilitates ongoing positive communication between Medical Management operations, behavioral health providers and other stakeholders in order to promote effective day to day problem solving. This individual demonstrates professional excellence, personal and professional integrity and collaboration with all colleagues. This position will apply continuous Performance Improvement strategies to Utilization Management activities.
The Clinical Manager develops and leads their staff in the activities required to execute the program activities in order to facilitate and support quality, cost effect outcomes and minimize fragmentation of health care delivery. The Clinical Manager is a coach and mentor to the staff they oversee, leading by example. Overall the Clinical Manager is accountable for their staff accomplishing the business goals and motivating them to achieve their purpose. This position will support and operate within a comprehensive call center Utilization Management Team.
Responsibilities:
Staff development and training.
Serves as a mentor and advocate for staff.
Leads by coaching staff, helping staff to higher levels of performance.
Accountable for hiring high functioning and effective resources.
Retention of staff.
Performance management and evaluation.
Creates an environment that is able to attract and retain staff.
Change facilitation.
Models accountability and expects the same from staff.
Identifies opportunities for continuous improvement.
Participates in continuous improvement as SME.
Networks/communicates with peers to facilitate operational standards and improvements.
Understands and uses the data to manage the team.
Communicates with staff in a comprehensive manner.
Accountable for operational discipline.
Meets business goals and objectives.
Collaborates with Medical, Site Directors and other senior leaders.
May have on-call responsibilities.
Competencies:
Experience or knowledge of integrated models of service coordination.
Knowledge of Motivational Interviewing/Engagement.
Strong clinical experience working with recipients and providers of behavioral and medical care.
Coaching experience.
Strong written and verbal communication skills.
Strong critical thinking skills.
Strong ability to influence and motivate.
Understanding of change and ability to move staff along the continuum of change.
Excellent conflict management skills and skills in collaboration with others.
Able to work under pressure.
Strong ability to prioritize.
Location:
Position is located in the Richardson, TX area.
If you're ready to help make health care work better for those who serve our nation. If you are smart, creative, and committed. If you want to make a difference. Consider being part of the elite team at UnitedHealth Military & Veterans Services.
Qualifications
Current RN licensure (and practice as Psych RN) or licensure in clinical mental health field.
Bachelor's degree required at the RN level or Master's degree required in a mental health field (e.g. Social Work, Psychology).
5+ years of psychiatric nursing or mental health practice.
3+ years of supervisory experience.
Previous experience in Utilization Management activities.
Preferred candidate will have behavioral health disease managment experience in Depression/Anxiety programs.
Preferred candidate will have experience in a managed care operation, involved in a contract ramp up.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
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.
