The Behavioral Health Home Consultant (BHHC) is responsible for the ongoing clinical management and quality oversight of Optum’s Behavioral Health Homes (BHH). The BHHC will be responsible for developing relationships with the BHH agencies and driving a quality improvement process to improve quality, improve clinical outcomes, increase efficiency and reduce overall benefit expense. The BHHC will monitor BHH performance and compliance with contractual obligations, provide tools to assist with performance and compliance, and is accountable for driving BHH performance improvement. As the single point of clinical contact for a practice, the BHHC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within Optum and the BHH.
The BHHC must demonstrate strong clinical and analytic skills, strong oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities/groups and/or providers. This BHHC will work closely with Care Advocacy Operations, Affordability, Network Management teams and other relevant departments to affect desired outcomes with the Integrated Health Homes as it relates to treatment for our membership.
If you are located in Nashville or Memphis, Tennessee, you will have the flexibility to telecommute* as you take on some tough challenges.
- Build and effectively maintain relationship with the BHH leadership and key clinical staff
- Regularly facilitate oversight meetings with the BHH to monitor, present, and discuss performance
- Monitoring BHH performance on program metrics, quality outcomes and adherence to contract requirements
- Conduct BHH program audits and provide feedback and results
- Identify performance improvement opportunities through analysis of operational data, clinical outcome data and utilization/claims data
- Communicate with BHH agencies to initiate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with contractual obligations
- Initiate and monitor Performance Improvement Plans to drive performance
- Monitor and report effectiveness of interventions
- Modify interventions as appropriate
- Support those high performing Integrated Health Homes such that performance remains at a high level
- Provide clinical and care coordination support
- Deliver education and training
- Interface with other OHBS departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement
- Licensed master's degree-level clinician in psychology, social work, counseling, or marriage and family counseling, Licensed Ph.D. / Psy.D. Level Psychologist or Registered Nurse
- Licenses must be active and unrestricted in the state of Tennessee
- Experience interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change
- Experience identifying performance improvement opportunities and influencing quality metrics
- Demonstrated experience leading groups and strong presentation skills
- Intermediate proficiency level with MS Office
- Ability to balance contractual and clinical considerations
- Willingness to travel approximately 25% for face to face meetings
- 3+ years of Managed Care and/or Utilization Review experience in a Managed Care setting is highly preferred with experience working with facility/group based care advocacy
- 3+ years (POST - LICENSURE) direct behavioral health clinical experience
- Working knowledge of Public Sector benefit plans
- Excellent time management and prioritization skills
- Strong relationship building and influencing skills
- Strong written and verbal communication skills
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.