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UnitedHealth Group Manager of Medical Management - Draper, UT in Draper, Utah

Manager of Medical Management oversees the OptumCare-Utah Care Management programs and teams. This department serves members across the continuum of care (inpatient/outpatient admissions, transitions in level of care, community services). The manager ensures policies and procedures are being followed and measures the efficacy of the program. The manager will evaluate regulatory changes and determine steps needed to implement into the Care Management programs. The manager will identify and implement business development opportunities to support growth and ensuring the program meets affordability goals. They will interact and collaborate with interdisciplinary care team, which includes physicians, transition care managers, pharmacists, social workers, and other health care professionals.

If you are located in the greater Wasatch Range, you will have the flexibility to telecommute*. Telecommuting from out of state is not possible for this position. External candidates are eligible for a $3,000 sign on bonus!

Primary Responsibilities:

  • Develop policies, procedures, and guidelines

  • Support Care Management teams including acute, post-acute, home health, social work, and short-term case management

  • Evaluate regulatory changes and determine steps needed to implement in programs

  • Develop Care Management program goals and measure impact to affordability

  • Identify and implement business development opportunities to support growth of the Care Management programs

  • Measure employee performance against internal procedures and protocols

  • Responsible for data collection and identification of trends/strategic planning

  • Drive implementation of best practices and standards that direct operational efficiencies

  • Work collaboratively with network providers/specialists, PCP Network, and internal departments to ensure high quality of care for our patients

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.

Required Qualifications:

  • Bachelor’s degree and current, unrestricted RN license

  • 1+ years’ experience leading a multi-disciplinary team

  • CMSA standards of practice knowledge

  • CCM and/or MCG Utilization certification/s or required within first year of employment

  • Medicare and Managed Care work experience

  • Experience in utilization review

  • You will be required to adhere to UnitedHealth Group’s US Telecommuting Policy.

  • 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 a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:

  • Master’s degree in related area

  • Experience in Home Health, Hospice and/or Community-Based setting

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.