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Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.
Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?
Manager Case Management (RN) - Florida - TRICARE-314719
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Description UnitedHealth Military & Veterans Services is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.
We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the South.
Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever. Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions.
It's not just business as usual. It is one of our proudest endeavors.
The Manager Case Management is responsible for clinical operations across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating), and includes case management, coordination of care, and medical management consulting. This role may also be responsible for providing health education, coaching and treatment decision support for members. This role manages RNs, RN Supervisors, and support staff who identify, coordinate, or provide appropriate levels of care, while working closely with Product Development and Medical Directors.
Purpose of Job:
- The Manager of Case Management is
- is responsible for the overall performance of the UMVS Case Management clinical program supporting TRICARE beneficiaries.
- develops and leads their staff in activities required to perform the programs activities in order to facilitate and support quality, cost effect outcomes, minimize fragmentation of health care delivery and provide exceptional customer service to military health care beneficiaries.
- coaches and mentor to the staff they oversee, leading by example.
- supports their staff in operating across the continuum of telephonic case management (assessing, planning, implementing, coordinating, monitoring and evaluating), partnering with utilization management, disease management, customer service, and claims with the overall goal of empowering the beneficiary to meet his/her health care goals.
- accountable for their staff accomplishing overall Case Management program goals and ensuring the delivery of exceptional Case Management services.
- participates in the development of program strategy to achieve clinical objectives
- works effectively to promote professionalism and secure staff case management certification and accreditation goals are met
- leads and develops clinical strategies to ensure Case Management services meet the needs of military beneficiaries, the military treatment facilities and other key stakeholders
- ensures beneficiary satisfaction benchmarks are met
- maintains professional working relationship with other UMVS departments, Military Treatment Facilities to stay abreast of military clinical program needs and program/product changes
- executes and maintains clear and concise communication channels between CM, other clinical areas, regarding issues, program status and performance metrics
Responsibilities:
Develop and maintains effective tools to ensure staff has excellent working knowledge of the military health care system, military communities and the unique challenges of military health care beneficiaries
Develop and maintain effective tools to ensure staff continually provide health care advocacy for the military health care beneficiary
Staff development and training.
Serves as a mentor and advocate for staff.
Leads by coaching staff, helping staff to higher levels of performance.
Accountable for hiring high functioning and effective resources.
Retention of staff.
Creates an environment that is able to attract and retain staff.
Change leader.
Models accountability and expects the same from staff.
Identifies opportunities for continuous improvement.
Participates in continuous improvement as SME.
Networks/communicates with peers to facilitate operational standards and improvements.
Understands and uses the data to manage the team.
Communicates with staff in a comprehensive manner.
Accountable for operational discipline.
Meets business goals and objectives.
Collaborates with Medical, Site Directors and other senior leaders.
Collaborates with key UMVS departments and stakeholders as applicable.
Responsible for performance management of staff.
Competencies:
Experience working with new/innovative business environments
Strong desire to work with and support the health care needs of the military population
Coaching experience.
Strong written and verbal communication skills.
Strong critical thinking skills.
Strong ability to influence and motivate.
Understanding of change and ability to move staff along the continuum of change.
Excellent conflict management skills.
Able to work under pressure.
Strong ability to prioritize.
If you're ready to help make health care work better for those who serve our nation. If you are smart, creative, and committed. If you want to make a difference. Consider being part of the elite team at UnitedHealth Military & Veterans Services. Qualifications
U.S. Citizen
Current RN licensure without restrictions.
Masters degree preferred.
Applicable certifications (CCM preferred)
Experience with TRICARE, military and/or military populations preferred
10+ years of case management experience preferred
Staff Coaching/Training experience
Excellent clinical skills and judgment
Experience working in an integrated case management (Medical/Behavioral Health) environment
Successful management experience
Ability to work in multidisciplinary environment integrating civilian and military health care system resources
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. |
