Behavioral Health Network Manager

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)

The Behavioral Health Network Manager (BHNM) is responsible for supporting a high-quality integrated care experience for our patients & driving superior overall behavioral health performance in assigned region.

The BHNM will drive value by ensuring access to quality behavioral care, supporting appropriate care plan documentation & coding, enabling collaboration between primary care & behavioral health providers, and partnering cross-functionally to address negative BH trend.

This position is expected to build and sustain strong working relationships with cross-functional departments, facilities and assigned providers.

Primary Responsibilities:

• Support primary care providers with education, tools and support for behavioral health care planning, coding & documentation accuracy, and compliance with applicable regulatory guidelines (e.g., CMS; HEDIS/STARS Quality Measures). Includes regular review of performance analytics & direct engagement with providers to ensure goal achievement
• Evaluate regional behavioral health performance including both inpatient and outpatient spend & trend. Partner with local CMO, regional BH clinical team, Optum Behavioral Health Services team, and other key stakeholders to understand key drivers and develop targeted improvement initiatives
• For behavioral health providers with value-based contracts, provide ongoing education, data/reporting & support to ensure goals are achieved
• Serve as liaison between primary care and behavioral health providers to ensure ongoing collaboration and open communication regarding patient care
• Ensure behavioral health network consistently meets network adequacy and access standards & partner cross-functionally to address concerns
• Other duties as assigned

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:

• Bachelor's Degree or equivalent work experience
• 5+ years of experience with a managed care organization or health insurer, or as a consultant in a health insurance network/contract management role
• Experience working with behavioral health providers
• Demonstrated understanding of health insurance coding and documentation
• Proficiency with Microsoft Office
• Access to reliable transportation & ability to travel up to 50% within assigned region

Preferred Qualifications:

• Expertise in physician/facility/ancillary contract reimbursement methodologies
• Established knowledge of local behavioral health provider community
• Experience managing provider relationships

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

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.