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About UHG

Careers at UnitedHealth Group

 

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:

Medical and Clinical Operations

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

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Senior Clinical Program Manager - Telecommute in Hawaii

UHG - Honolulu, Hawaii

Posted: 12/7/2018

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

 

If you are located in Hawaii, you will have the flexibility to telecommute* as you take on some tough challenges. Must to able to travel to the office and throughout the community and state of Hawaii as needed.

 

Primary Responsibilities:                                     

  • Clinical program management across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating)
  • Management of DSNP program and staff:
    • Manages the daily workflow and operations of the Dual Special Needs clinical program including ensuring appropriate coverage and staffing levels
    • Manages the day to day workflow of the DSNP staff, establishing work assignments, setting priorities and ensuring completion of assignments within the established time-frames
    • Ensures compliance with DSNP regulatory requirements
    • Maintains compliance with ongoing DSNP audit and business monitoring requirements
    • Sets team direction, resolves problems and provides guidance to members of the team
    • Ensures team meets established performance metrics and performance guarantees
  • Takes lead role in setting direction and participating in or developing new programs
  • Assumes responsibility for other clinical programs and associated staff to meet state contract requirements or other regulatory needs or as assigned by Clinical VPs (i.e. Going Home Plus Program, activities related to Case Management Agencies, pediatric program management, disease management)
  • Adapts departmental plans and priorities to address business needs and operational challenges
  • Serves as resource to other managers regarding issues that affect their departments
  • Identifies opportunities for staff development or training and coordinates/delivers the training as needed

Required Qualifications:

  • Current, unrestricted RN or SW license in the State of Hawaii
  • 3+ years’ experience in a clinical setting (acute or long term care)
  • 2+ years’ experience in a managed care setting (service coordination, care coordination, case management)
  • Experience in member assessments and care plan development
  • Knowledge of community resources across all islands
  • Experience with vulnerable/disadvantaged/low-income populations
  • Experience with clinical documentation systems
  • Experience in navigating a Windows environment and comfortable in the use of Microsoft Word, Excel, Visio, and Webex

Preferred Qualifications:

  • 3+ years of supervisory/management experience
  • Experience working with members enrolled in both Medicare and Medicaid
  • Experience in transitional care/discharge planning
  • Certified Case Manager (CCM)
  • Experience in utilization review, concurrent review and / or risk management
  • Experience in developing and delivering training in live or web-based settings

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

 

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.

 

 

Keywords: RN, Registered Nurse, SW, Social Worker, Clinical Manager, Case Manager, Service Coordinator, Program Manager, Project Manager, clinical, acute, long term care, managed care, Medicare, Medicaid, CCM, HI, Hawaii, Honolulu, Telecommute

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