Clinical Program Manager, Utilization Management - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The overall purpose of the Clinical Program Manager, Utilization Management position is to manage a team of licensed care advocates performing utilization management activities. The manager will ensure that the team is functioning at optimal effectiveness and efficiency by continuously monitoring team performance and taking corrective action when necessary. The manager should be a mentor and role model who encourages the team to strive toward excellence and professionalism.

The business hours for this position are between 7:00 AM - 6:00 PM CST, including flexibility with starting and ending times based on business needs and a holiday rotation.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Manages and is accountable for clinical behavioral health professional employees and non-clinical staff

• Sets team direction, resolves problems and provides guidance to members of own team

• Adapts departmental plans and priorities to address business and operational challenges

• Influences or provides input to forecasting and planning activities

• Ability to prepare and present to a group during customer audits or meetings

• Monitors, manages and controls operational and performance metrics in conjunction with established program value targets

• Develops solutions to address new, often complex customer requirements that address operational, clinical and customer needs

• Ensures audits are conducted, standards are met, and successful outcomes are achieved

• Reviews operational and performance metrics regularly and partners with direct supervisor in driving action plan development and execution

• Collaborates with cross functional teams across the organization, including medical, network, implementations, regulatory/compliance, claims, senior leaders and other stakeholders

• Lead and participate in team and stakeholder meetings

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:

• Licensed Master's degree in Psychology, Social Work, Counseling, or Marriage or Family Counseling; Licensed Ph.D.; or an RN with 2+ years of experience in behavioral health

• Active, unrestricted clinical license that allows you to practice independently without supervision

• 5+ years of post-licensure Behavioral Health experience

• 3+ years of people management experience (i.e., managing direct reports, coaching, training, performance reviews, running team meetings, etc.)

• Proficient Microsoft skills (Word, Excel, Outlook)

• Proficiency and experience with multiple computer systems

• Access to high-speed internet for home office set up and a dedicated work space at home

Preferred Qualifications:

• Experience managing staff/direct reports to metrics

• Experience working with Commercial and Medicaid populations

• Dual diagnosis experience with mental health and substance use

• Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients

• Case Management experience

• Managed Care experience

• Proven ability to coach, develop and mentor a team that is remote from home

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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.

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.