HSS Manager, Hamilton and Bradley Counties - Remote in TN

About the position

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. The Manager of Care Management (MCM) is responsible for providing oversight of long-term care (LTC) and home and community-based (HCBS) services. The care coordination team facilitates, promotes, and advocates for the member's ongoing self-sufficiency and independence. This includes assessing the availability of natural supports, representative or family members to ensure the ongoing mental and physical health of those natural supports. The position requires 40 - 60% local travel and 10 - 15% statewide travel. If you are located in or within commutable driving distance to Hamilton and Bradley Counties in Tennessee, you will have the flexibility to work remotely as you take on some tough challenges. The MCM will supervise, direct, and evaluate a diverse group of health care professionals to assure effectiveness of care coordinators' activities. Responsibilities include routinely assessing and monitoring members' status, needs, and progress; developing individual plans of care; managing critical transitions; coordinating appropriate treatments and services; identifying and communicating opportunities for care intervention; authorizing care services; and monitoring the provision of covered services as a cost-effective alternative. The MCM will also develop and implement targeted strategies to improve health, functional, and quality of life outcomes, proactively educate members, and maintain ongoing communications with members, their authorized representatives, and providers. In addition, the MCM will be responsible for interviewing, hiring, disciplining, evaluating, and mentoring a diverse care coordination workforce. This includes onboarding new staff, conducting training for maximum performance, and promoting teamwork and a positive working environment. The MCM will monitor staff performance, create development plans for direct reports, and ensure compliance with contractual obligations. The role also involves performing comprehensive member assessments, developing plans of care, and ensuring contract compliance for new member outreach and service initiation. The MCM will serve as the primary support for technologies used by the team and will perform ride-along visits to observe employee performance.

Responsibilities
? Supervise, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordinators activities.
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? Routinely assess and monitor members' status, needs and progress; develop individual plans of care for members.
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? Manage critical transitions, coordinate appropriate treatments and services, and identify opportunities for care intervention.
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? Authorize care services and monitor the provision of covered services as a cost-effective alternative.
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? Develop and implement targeted strategies to improve health, functional and quality of life outcomes.
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? Proactively educate members and conduct, review and revise member's risk assessments and risk agreements.
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? Maintain appropriate and ongoing communications and collaborations with members, their authorized representatives and providers.
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? Report quantifiable impact, quality of care and quality of life improvements as measured against care coordination goals.
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? Interview, hire, discipline, evaluate and mentor a diverse care coordination workforce.
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? Conduct onboarding for new staff including pre-employment tasks and ordering of necessary equipment.
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? Provide training for maximum performance and developmental opportunities for staff.
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? Promote teamwork and a positive working environment for care coordinators.
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? Monitor performance of staff including service performance and adherence to established benchmarks.
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? Create and monitor development plans for direct reports needing additional coaching.
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? Develop and implement Corrective Action Plans for direct reports not meeting performance expectations.
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? Participate in the MAP process, developing annual MAP goals for direct reports and monitoring progress.
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? Staff a case load of members when dictated by census fluctuation or staffing coverage.
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? Perform comprehensive member assessments and ensure contract compliance for new member outreach and service initiation.

Requirements
? Registered Nurse with active license in the state of Tennessee or Master level Social Worker with active license in the state of Tennessee.
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? 3+ years supervisory/management experience (direct supervision, team lead, SME, preceptor).
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? 2+ years of relevant health care experience, preferably in managed and/or long-term care.
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? Intermediate to advanced software application and hardware expertise.
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? Ability to work within highly structured contractual time compliance requirements.

Nice-to-haves
? 3+ years of experience providing care coordination to persons receiving long-term care and/or home and community based services.
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? Advanced skills in critical thinking, follow through, organization, written and verbal communication, problem-solving, and human relation skills.

Benefits
? Flexible work environment with remote options for eligible employees.
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? Opportunities for professional development and career growth.
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? Comprehensive health insurance coverage.
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? Supportive team culture and positive working environment.

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