Value Based Program Consultant Maryland Telecommute

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

The Value Based Program Consultant (VBPC) is responsible for the ongoing clinical management and quality oversight of the Maryland Behavioral Health Home (BHH) Program. The VBPC will be responsible for developing relationships with Behavioral Health Home providers, driving a quality improvement process to improve quality, improve clinical outcomes, increase efficiency and reduce overall benefit expense. The VBPC will monitor Provider performance and compliance with contractual obligations, provide tools to assist with performance and compliance, and is accountable for driving performance improvement. As the single point of clinical contact for a practice, the VBPC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within Optum and the Provider.

The VBPC must demonstrate solid clinical and analytic skills, solid oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities/groups and/or providers. This VBPC will work closely with Care Advocacy Operations, Affordability, Network Management teams and other relevant departments to affect desired outcomes with contracted Providers as it relates to treatment for our membership.

If you are located within commuting distance to Maryland, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Build and effectively maintain relationship with the Provider leadership and key clinical staff
• Conduct Provider program audits and provide feedback and results
• Deliver education and training
• Facilitate oversight meetings as needed with the Provider to monitor, present, and discuss performance
• Monitoring Provider performance on program metrics, quality outcomes and adherence to contract requirements
• Identify performance improvement opportunities through analysis of operational data, clinical outcome data and utilization/claims data
• Communicate with 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 agencies such that performance remains at a high level
• Provide clinical and care coordination support
• Interface with other OHBS departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement

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:

• Independently Licensed, Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D./Psy.D. Level Psychologist or Registered Nurse
• Licenses must be active and unrestricted in the state of Maryland
• Experience in 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 solid presentation skills
• Ability to balance contractual and clinical considerations
• Willingness to travel approximately 25% for face-to-face meetings
• Designated secure workspace and access to install secure high speed internet via cable/DSL in home

Preferred Qualifications:

• 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 of (POST- LICENSURE) direct behavioral health clinical experience
• Working knowledge of Public Sector benefit plans
• Excellent time management and prioritization skills
• Solid relationship building and influencing skills
• Solid written and verbal communication skills
• Solid computer skills at the intermediate level, proficiency with MS Office
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

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