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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:




Approximate Salary:

Not Specified

Position Type:

Full Time

Clinical Team Lead, Long Term Care - OH

UHG - Toledo, Ohio

Posted: 12/17/2018

This Clinical Team Lead covering Ohio with the flexibility to travel.


Primary Responsibilities:


Supervisory Responsibilities – Approximately 70%

  • Partner with the Clinical Service Manager and Director of Clinical Operations to ensure effective on boarding of new  and ongoing development for existing staff
  • Utilize knowledge of geriatric/chronic disease management to provide coaching and mentoring for new and existing 4-5 Nurse Practitioners
  • Serve as a resource on escalated case management issues
  • Provide individualized learning/growth opportunities for the clinical team that promote development and retention of clinical staff
  • Accountable for financial targets related to clinical programs
  • Manage implementation and adoption of clinical and quality initiatives
  • Communicate needs surfaced by staff to the appropriate leadership
  • Partner with stakeholders to identify and resolve problems
  • Ability to communicate clinical priorities based upon business and financial goals
  • Serve as a clinical expert on business development efforts
  • Actively participate in local/regional Provider (NP, PA) associations to develop clinical and leadership skills, promotion of Complex Population Management model, and developing a network of Providers for future career opportunities
  • Manage special projects/ programs as needed
  • Promote the development of a collegial team (for coverage, trouble shooting, and brain storming)
  • Foster and develop a culture of clinical expertise
  • Serve as a role model to internal and external partner

Primary Care Delivery

  • Deliver cost-effective, quality care to assigned Complex Population Management members in collaboration with their assigned physicians
  • Manage medical and behavioral chronic and acute conditions effectively
  • Perform comprehensive assessments and documents findings in a concise/comprehensive manner that is compliant with Complex Population Management visits and documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations
  • Facilitate agreement and implementation of the member’s plan of care by engaging the facility staff, families/responsible parties, primary and specialty care physicians
  • Evaluate the effectiveness, necessity and efficiency of plans, making revisions as needed
  • Utilize practice guidelines and protocols established by Complex Population Management
  • May be required to participate in on-call program 

Care Coordination

  • Understand the Payer’s/Plan benefits and associate policies and procedures, and articulates them effectively to, members, and key decision-makers
  • Assess the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of any skilled benefit events Communicate process in accordance with Complex Population Management expectations
  • Coordinate care as members transition through different levels of care and care settings
  • Ongoing monitoring of members and family needs
  • Evaluate plans for cost effective services that provide agreed upon outcomes for members, families and to decreases high costs, poor outcomes and unnecessary hospitalizations

Program Enhancement Expected Behaviors

  • Regular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, Complex Population Management staff and other provider or payer groups
  • Exhibits original thinking and creativity in the development of new and improved methods and approaches to concerns/issues
  • Function independently and responsibly with minimal need for supervision
  • Demonstrate initiative in achieving individual, team and organizational goals and objectives     

Required Qualifications:

  • Prior experience as a NP in a long term care or community setting for a minimum of one year

  • Proficient computer skills including the ability to document medical information with written and electronic medical records
  • Certified nurse practitioner through ANCC/AANP for adult, family and/or geriatrics (GNP preferred)
  • Masters prepared in compliance with state licensure requirements
  • Current unrestricted license in state(s) in which practicing
  • Unrestricted DEA (license to prescribe narcotics/level II info here) per state regulations (unless prohibited in state of practice)
  • Ability to lift up to 40 pounds
  • Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area   

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


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.

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



Job Keywords: long term care, NP, Nurse Practitioner, ANCC, AANP, home care, adult care, Lima, Toledo, Columbus, OH, Ohio

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