14 days old

Market Clinical Manager - Telecommute in Baton Rouge, LA or New Orleans, LA - 908802

New Orleans, LA 70112 Work Remotely
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  • Job Code
    908802

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

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"Clinical Manager of Non-SNP Care Coordination will organize and manage the daily operations for the regional team to ensure the effective planning and coordination in the assessment and care planning of members. The manager assists with monitoring of compliance with clinical policies; assists with implementation of regulatory requirements; and provides staff training support and performs other duties as outlined by the Clinical Director of Non-SNP Care Coordination.

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The Manager provides oversight of staff engaged in care coordination activities and case management of members while ensuring appropriate value based, quality care is provided.

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If you are located within Baton Rouge, LA or New Orleans, LA, you will have the flexibility to telecommute* as you take on some tough challenges.

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Principal Responsibilities:

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  • Improve health care quality and increase likelihood of desired health outcomes
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- Facilitates communication and coordination between all members of the health care team.
" - Provides clinical guidance in matters of assessment, care planning, documentation, provision of services, and care coordination
" - Participates in evaluations of the quality and effectiveness of assessment and care planning for population based on risk status

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  • Prevent hospital readmission
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- Identifies and coordinates benefit options for the member and/or care giver to overcome potential barriers from discharge to an alternate level of care
" - Monitors performance against assigned members gaps in HEDIS and Star measures through weekly report analysis

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  • Implement activities to improve patient safety and reduce medical errors
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- Participates with the interdisciplinary care team in review of assigned members

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  • Provide and support wellness and health promotion activities
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- Collaborates with members of the interdisciplinary care team and medical director(s) to facilitate appropriate treatment for members
" - Utilizes evidence-based guidelines in their daily practice
" - Provides leadership, assists with ongoing evaluation of programs and staff compliance. Assists with documentation of staff performance of assigned staff
" - Provides continuing education and coaching to staff

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  • Support health information technology (HIT) in health care quality improvement
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- Works in coordination company-based security health information systems technology to ensure appropriate documentation of the members care coordination and record
" - Participates in ongoing training to ensure the records are accurate and secure
" - Follows corporate instruction based on Federal and State guidance related to health information documentation and security

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Management Responsibilities:

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  • Monitors both department and individual staff performance, providing ongoing feedback
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  • Maintains appropriate staffing levels required to meet departmental goals
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  • Interviews candidates and makes hiring decisions as needed
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  • Identifies opportunities for staff development and coordinates training as needed
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  • Ensures staff members meet all required licensing, compliance and Compliance Wire requirements
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  • Completes timely and thorough evaluations of staff
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  • Functions as a mentor to staff regarding career goals within Peoples Health
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  • Proactively manages employee relations issues, utilizing a progressive corrective action plan including appropriate documentation
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  • Serves as a resource to other managers regarding issues that impact their departments
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  • Develops, manages and works within department budget
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  • Ensures compliance by maintaining knowledge of industry trends and legislation related to department
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  • Ensures timely review and updating of departmental policies, procedures, training manuals and job descriptions as neede
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Supervisory Responsibilities:

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  • Manages the daily work flow and operations of department including ensuring appropriate coverage
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  • Handles escalated operational issues as needed and knows when to involve management
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  • Assists Clinical Director of Non-SNP Care Coordination in identifying appropriate staffing levels required to meet departmental goals
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  • Identifies opportunities for staff development and works with management to coordinate/provide training as needed
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  • Assists with development and maintenance of department training manuals
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  • Plays an active role in staff training/development initiatives
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  • Provides input to management regarding employees strengths and necessary improvement
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  • Serves as a resource to staff and Clinical Director of Non-SNP Care Coordination regarding issues that impact their department
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Reports to the Clinical Director of Non-SNP Care Coordination and has the management responsibilities of the staff to include:
"-Care Coordinator - Registered Nurse
"-Care Coordinator - Social Worker
"-Office Navigator
"-Administrative Assistant/Clerical Support
"-Other staff as assigned

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Responsibility: To continue to strive to be the best for our members by adapting and evolving to change, continuing professional development, and to never stop learning
"Excellence: By exceeding expectations and finding innovative ways to exceed standards, we are changing our members lives

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Youll 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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Required Qualifications:

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  • Current Louisiana RN license
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  • Diploma or degree in nursing
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  • 3+ years of experience in clinical or similar setting
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  • Experience with clinical documentation systems
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  • Experience in assessing members and developing care plans
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  • Possible exposure
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • Bachelors in Nursing
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  • Peoples Health employee for one (1) year
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  • 1+ years supervisory experience
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  • Experience in management care industry
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  • Familiarity with NCQA structure and process measures and CMS Medicare managed care regulations
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  • Understanding of HMO and third-party administration
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  • Continuing education in the healthcare/managed care industry
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  • Strong organizational skills, attention to detail, verbal and written communication skills
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Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Market Clinical Manager, Clinical Manager, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Baton Rouge, New Orleans, Louisiana, LA

Posted: 2021-02-16 Expires: 2021-03-18

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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Market Clinical Manager - Telecommute in Baton Rouge, LA or New Orleans, LA - 908802

UnitedHealth Group
New Orleans, LA 70112

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