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UnitedHealth Group Supervisor, RN HEDIS Strategy West Coast Region in Salt Lake City, Utah

This position will be responsible for supervising a team of field based RN case managers. RNs are based in physician offices overseeing the care of Medicare and Retirement members ensuring that recommended preventative health screenings are completed and gaps in care are addressed. Travel may be required both within the state and out of state. Must live in the state of Montana, Wyoming, Colorado, New Mexico, Arizona, Utah, Idaho, Oregon or Nevada. This role is based out of the employee's home to telecommute* 50% of the time.

Primary Responsibilities include but are not limited to:

  • Supervising nursing staff and review their performance metrics

  • Provide coaching and mentoring to staff members who are not meeting production standards

  • Conduct training sessions to educate staff on new processes and procedures

  • Conduct 1-on-1 meetings with staff and perform quality audits

  • Serve as a subject matter expert on system and processes

  • Handle escalated issues

  • Travel both in state and out of state to visit physician practices and staff as needed

  • Leverage clinical acumen to provide guidance to staff (e.g., disease state, health conditions)

  • Assist staff in navigating the medical management system (e.g., find resources, answers questions)

  • Provide oversight and review of coordination of care (e.g., chronic condition management, utilization management, case

  • management)

  • May be assigned to a physician practice and manage a patient case load

  • May assist with new physician practice implementations and relationship management

  • Ensure employees are current with clinical licensure and certifications

  • Develop and communicate performance metrics and expectations

  • Direct data collection and measurement of outcomes (e.g., customer surveys)

  • Apply metrics to evaluate services, employee performance, and program outcomes

  • Read and interpret reports (e.g., performance, service)

  • Identify causes of performance deficiencies and determine appropriate follow up actions

  • Drive implementation of best practices and standards

  • Complete other duties as assigned

Required Qualifications:

  • Current, unrestricted RN license in the State

  • 3+ years of clinical experience as a Registered Nurse in a hospital, acute care, home health, direct care or case management

  • 1+ year of staff management experience

  • Computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications

  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others

  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities.

  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect.

  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s).

  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer.

  • Must have a distraction free area in home for home office

  • Must have access to high speed internet (DSL or cable)

  • Must be able to travel at least 50% of the time, which could include out of state/overnight travel

Preferred Qualifications:

  • Bachelors of Science in Nursing

  • Case Management experience including Certification in Case Management

  • Experience in intensive care (ICU) or emergency department (ER) nursing

  • Prior Physician Office experience

  • Home care/field based case management

  • Medicaid, Medicare, Managed Care experience

  • Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs

  • Call Center experience

  • Experience in working with patients in Home and/or Community based setting

  • Experience with EMR (electronic medical records)

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)

*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, case manager, case management, CCM, HEDIS, EMR, electronic medical records, team lead, supervisor, STARS, Medicare, audit, quality measures

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