Remote Hybrid Manager – Clinical Care Coordination – ALTCS – Maricopa County, AZ

UnitedHealthcare

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Requisition Number: 2229401
Job Category: Medical & Clinical Operations
Primary Location: Phoenix, AZ
(Remote considered)

For more information about this role and others, please join us for a virtual hiring information session with Jean Kalbacher, Health Plan CEO and Francine Pechnik, Executive Director, our recruiters, benefit specialists and other health plan staff, to learn more about our organization, roles available and next steps. 

The virtual event is Tuesday, June 4th, at 12:00pm AZ Time

To register for the event, please visit: https://uhg.hr/C&SArizonaInformationSession1

To view available roles and apply visit: https://uhg.hr/C&SArizonaOpenRoles

Roles available include Field Care Coordinator, Clinical Coordinator, Clinical Quality LPN, Clinical Quality RN, and other supporting roles.

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

Purpose of Job:

To lead a team of case managers, while overseeing day-to-day clinical operations and participating in business development activities.  The person in this position will manage a program or region, including performance management, process improvement, and standardized execution of clinical decision processes, case manager team management and implementation of new program initiatives including global and regional medical affairs initiatives. Function also includes problem-solving at the member, family, and provider level.

This is a telecommute position and will require travel about 25%, and there will be some travel to the Phoenix office as needed.

If you are located in Maricopa County, AZ, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities: 

  • Excellent Communication skills, possess de-escalation skills and ability to interrelate with individuals at various level and in various functional areas throughout the organization and to develop effective business relationships
  • Identify, select, structure, and prioritize process improvement projects and revises to meet changing needs and requirements
  • Follow up with workgroup team members as appropriate
  • Lead one or more projects across internal and or external divisions or areas
  • Participates in program development/initiative workgroups within UnitedHealth Group
  • Manages utilization program as a result of day-to-day management and successful implementation of initiatives
  • Creates a team-oriented management environment, enhancing the integration between the clinical and operations sections of medical affairs
  • Manages mentors and supports staff in designated department or region
  • Engage in regular auditing activities with the ability to provide focused education individually as well as across the team as patterns emerge
  • Develops clear goals and objectives for performance management and effectively communicate accountability
  • Assists with design and implementation of global and regional medical affairs initiatives
  • Assists in strategic development of medical affairs processes to ensure that efficient and systematic operational plans are created and executed
  • Ensures standardized execution of workflow processes, such as authorizations and non-certifications and analyze outcomes of standardized audits for AHCCCS, NCQA, HEIDIS purposes
  • Acts as regional interface with other departments to coordinate workflow processes and implementation plans
  • Assists in the development and execution of educational programs to enhance staff development
  • Monitors performance metrics specific to functional area.  Evaluates metrics in addition to developing action plans to address variance from standards
  • Oversees team of case management staff, serves as a mentor, monitors adherence to state contract requirements and performance measure outcomes

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: 

  • Must meet one of the following:
    • Registered Nurse with a current AZ license who has a degree in psychology, special education, counseling, or degree in similar field
    • Degreed Social Worker or who has a degree in psychology, special education, counseling, or degree in similar field
    • Currently working as an ALTCS Supervisor in the state of AZ
  • At the time of starting, 3+ years of case management experience serving elderly and/or persons with physical or developmental disabilities
  • At the time of starting, 3+ years of supervisory experience
  • At the time of starting, 2+ years case management experience serving members determined to have a Serious Emotional Disability (SED) and/or Serious Mentally Illness (SMI)
  • Working knowledge of Microsoft Word, Excel, and PowerPoint
  • Basic knowledge of Medicare / Medicaid regulations
  • Proven ability to perform in a leadership role, training experience and regularly exercise independent judgment and discretion in handling of duties
  • Proven ability to function independently and responsibly with minimal need for supervision
  • Demonstrated solid written / grammar and communication skills, excellent time management skills, the ability to master new skills and ideas, able to adapt to change, and exhibit flexibility
  • Proven ability to exhibit original thinking and creativity in the development of new and improved methods and approaches to problems
  • Proven first rate customer service, interpersonal skills, detail oriented and self-motivation
  • Demonstrated initiative in achieving individual, team, and organizational goals and objectives
  • Proven effective team player
  • Demonstrated solid organizational skills
  • Willing or ability to travel locally up to 25% to visit members and providers in the community
  • Live in Arizona and in the service area and its vicinity

Preferred Qualification:  

  • Long-term care, home health and managed care experience, and care coordination

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.