Associate Director, Behavioral Health HEDIS Network Strategy

Requisition Number: 2354494
The Associate Director of Behavioral Health HEDIS Network Strategy leads development and execution of provider network initiatives that improve behavioral health quality outcomes with a primary focus on HEDIS and CMS Core Set measures (e.g., FUH, FUM, FUA). This role translates quality strategy into actionable network interventions and partners closely with behavioral health network providers and provider vendors to improve access, follow-up, and continuity of care.
The Associate Director will lead network initiatives and workstreams while collaborating and influencing with cross-functional partners to drive successful cross-matrixed interventions.
Key functions focus on:

• Operational execution within behavioral health networks
• Provider and facility level performance improvement
• Behavioral health liaison to medical networks
• Developing strategic solutions with a measure specific focus (e.g., FUH/FUM/FUA)
• Defined scope by market, product, or provider segment

Primary Responsibilities:

• Execute behavioral health network strategies that improve performance on priority HEDIS and Core Set measures.
• Partner with network and vendor outpatient, inpatient, and community based behavioral health providers to address access, timely follow-up, and care coordination gaps
• Support contracting and incentive strategies tied to behavioral health quality outcomes
• Collaborate with Network, Quality, Clinical, and Analytics teams to identify provider level opportunities
• Collaborate with medical Network teams on integrated care opportunities
• Use performance data to target interventions and monitor improvement
• Identify and escalate risks and progress to HEDIS leadership
• Support regulatory compliance and readiness related to behavioral health quality, including audits and EQRO reviews
• Contribute to provider education and best practice dissemination related to behavioral health HEDIS requirements
• Leverage existing and build new relationships with provider associations, facilities, and partners to remove barriers and improve HEDIS performance

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:

• 5+ years of related Managed Care experience in healthcare network operations building provider strategies and programs to improve quality, outcomes, and member experience, resulting in reducing avoidable cost
• 3+ years of Facility/Outpatient Provider Relations experience
• 3+ years of Network Management experience
• 3+ years of Strategic Planning experience
• 2+ years of experience presenting complex subject matter that can be easily understood by general audiences and senior leadership
• Experience leading cross-functional teams in a highly matrixed organization

Preferred Qualifications:

• Master's degree in social work, counseling, or clinical psychology
• Understanding of NCQA HEDIS Quality Measures
• Experience working at Optum Behavioral Health Solutions in Network (Contracting & Provider Relations)
• Demonstrated advanced data analytics skills
• Demonstrated advanced project management skills
• Demonstrated advanced interpersonal and communication skills

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.
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.
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.