Requisition number: 2350839
Job category: Business Operations
Optum Behavioral Health, part of the Optum family of businesses, is seeking a Clinical Delegation Oversight Coordinator to join our team. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone.
Serving as the primary liaison to Behavioral Health Administrative Service Organizations (BH-ASO), the Clinical Delegation Oversight Coordinator plays a vital, outward-facing role engaging with the Health Care Authority (HCA), BH ASOs and internal stakeholders. This position ensures effective oversight of services delegated to the BH ASOs, employing a streamlined, standardized framework to support consistency and excellence across all partnerships.
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. during Pacific Time Zone business hours 8am-5pm as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Lead and oversee delegated audit activities as defined in the Washington (WA) Delegation Oversight Program and auditing tool
Build collaborative relationships with the HCA, BH ASOs and internal stakeholders
Oversee delegation audit activities as outlined in the WA Delegations Oversight Program for approximately ten operational functional areas
Identify and ensure delegation subject matter experts (SMEs) monitor progress for timely compliance. In conjunction with delegation SMEs, implement corrective action plan(s), review outcomes and adjust until goals are met
Identify and develop with internal teams' reporting/dashboard or score cards that inform the delegated entities of their performance and provide clinical/operational shaping opportunities to improve contractual/clinical outcomes
Perform periodic clinical audits
Schedule and complete, at a minimum, quarterly performance meetings with delegees. If performance warrants, develop, implement and monitor the closure of collaborative/corrective improvement plans
Prepare and deliver necessary reporting, both written and verbal, demonstrating oversight of compliance
Monitor and participate in regulatory changes that affect delegated entities for WA Medicaid. Ensure delegee's are compliant and establish methods to measure compliance
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:
Unrestricted clinical licensure in the state of Washington (LMHC, LMFT, LICSW, Psychologist, RN with BH expertise)
5+ years of experience in public sector (Medicaid or Medicare)
5+ years of cross functional leadership experience in a matrix environment
5+ years of experience in regulatory or accreditation oversight
3+ years of experience in performing clinical audits
Demonstrated expertise in public speaking, confidently presenting complex information to diverse audiences
Demonstrated ability to use a PC in a Windows environment, including email and Microsoft Office applications
Ability to work Pacific Time Zone hours 8am-5pm
Ability to travel up to 10% as needed for annual audits/corrective plan remediation
Preferred Qualifications:
Experience in oversight of Quality Standards, including NCQA
Resident of the State of Washington
Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together.
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
