1+ months

Associate Health Services Director (MLTSS/LTC)

Iselin, NJ 08830
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  • Job Code
    856709

Clinical careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance

that's driving the health care industry forward. of seeing a handful of patients each day, your work may affect millions for years to come. Join us. And start doing your life's best 
work.(sm)
 

The Associate Health Services Director for Managed Long term Support & Services (MLTSS) is responsible for the clinical operations and medical management activities across the 

continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). Function provides leadership to and is accountable for the performance of

managers and / or senior level professional staff. 

 

This position may require travel in assigned region to conduct supervisory visits to members in their homes and/or other settings, including community centers, hospitals or providers' offices

 

Primary Responsibilities:

  • Executes the delivery of all Clinical Programs Case Management / Service Coordination and Disease Management within areas of responsibility for the Health Plans
  • Develops and implements clinical program structure and resource plans that are consistent with National Clinical Model based on populations serviced by Plan and revenue models
  • Ensures local service coordination processes, policies and procedures meet regulatory / NCQA / CMS standards and are consistent with the national clinical model
  • Leads, coaches, develops, clinical leadership staff, fosters innovation to improve member outcomes
  • Ensures monitoring and oversight of clinical programs / staff to meet defined goals / targets, contract requirements
  • Acts as administrative liaison between the health plan and the various State entities for the MLTSS Care Management requirements
  • Works collaboratively with providers, sister-segments, service contractors and health plan management to oversee the management of a health services department with the objectives of improving the quality of care delivered to members in a range of products, i.e., Medicaid, CHIP, SSI / ABD, long term care, and dually eligible categories, improving cost efficiencies and developing an environment of operational excellence
  • Interfaces with UHG enterprise to ensure clinical operations are compliant with State and Federal regulations
  • Develops, translates and executes strategies or functional / operational objectives for Health Plan including medical management, financial accountability, customer and Provider satisfaction, quality improvements
  • Develops and implements staff retention and engagement program
  • Ensures clinical staff training, onboarding, immersion and competency assessment processes meet contract requirements and clinical model standards
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.
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Posted: 2020-01-15 Expires: 2020-04-18

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Associate Health Services Director (MLTSS/LTC)

UnitedHealth Group
Iselin, NJ 08830

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