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
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
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
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