Behavioral Health Utilization Management Care Coordinator Team Lead (Project Based)

Job Ref: TE0106
Category: Utilization Review and Case Management
Department: BEHAVIORAL HEALTH HARP
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Temporary
Employment Type: Full-Time
Work Arrangement: Hybrid
Salary Range: $70,000.00 - $70,000.00

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Position Overview

The Behavioral Health Utilization Management (BH UM) Care Coordinator Team Lead provides oversight of the administration of departmental utilization management activities. The BH UM Care Coordinator Team Lead will act as the liaison between the medical and Behavioral Health UM and Case Management teams and work together with the other Medical Management Leadership to manage the department. The BH UM Care Coordinator Team Lead is expected to promote and facilitate a multidisciplinary approach to coordinate care, while also ensuring adherence to standards of care consistent with current professional regulations of the company.

Work Shifts

9:00 AM- 5:00 PM

Duties & Responsibilities

• Support the Behavioral Health Department in the full implementation and transition of all non-clinical
• UM functions into the Guiding Care platform.
• Conduct and support all phases of testing for new system features and releases:

-Functional testing

-End‑to‑end workflow testing

-User Acceptance Testing (UAT)

• Serve as a key operational resource for the Director of BH UM and BH UM Care Coordinator
• Supervisor during system design, configuration, testing, and rollout.
• Provide ongoing non‑clinical operational support and training to ensure UM workflows remain compliant, efficient, and aligned with regulatory requirements.
• Assist in maintaining required turnaround times for UM and appeals, which is critical for Article 44 readiness by end of 2026.
• Support cross‑functional coordination with other business areas impacted by Guiding Care workflows and system changes.
• Help sustain current UM service levels and compliance standards without reliance on unsustainable overtime usage.
• Assist all MetroPlusHealth departments with the resolution of the members’ issues related to BH UM
• Assist the Director of BH UM and BH UM Care Coordinator Supervisor with daily operational oversight and workload management.
• Provide guidance and support to BH UM Care Coordinators on non‑clinical tasks and system navigation.

Minimum Qualifications

• Associate’s Degree required; Bachelor’s Degree preferred.

• A minimum of 4 years’ experience in customer service; 2 years must be in a UM medical management call center setting.

• Prior supervisory, training or management experience preferred.

• Superior Technical Computer skills (Microsoft Office, Excel, Care Connect, Teams Video Application)

• Knowledge of Centers for Medicare & Medicaid Services (CMS), New York State Department of Health (NYSDOH)

• Demonstrated ability to manage large caseloads in a fast-paced environment while building and enhancing team productivity

• Demonstrated professionalism and leadership skills along with the ability to develop, direct and support staff

 

Professional Competencies:

• Integrity and Trust
• Teamwork and Problem-Solving Attitude
• Customer Focus
• Functional/Technical Skills
• Excellent written and oral communication skills required. Ability to multi-task well.
• Ability to work in a fast-paced environment
• High degree of diplomacy and tact

#LI-Hybrid #MPH50