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Role Description

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

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) contract oversight within behavioral health
• 5+ years of cross functional leadership experience in a matrix environment
• 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

• Resident of the State of Washington

Benefits

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
• 401k contribution (all benefits are subject to eligibility requirements)

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.