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UnitedHealthcare Community & State Senior Care Options plan is a Fully Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually eligible individuals in the Commonwealth of Massachusetts aged 65 or greater. This position reports to the Health Services Director in the Health Services Department within the Senior Care Options Plan. This position sets team direction, resolves problems and provides direction to nurse case managers. This position adapts departmental plans and priorities to address business and operational challenges such as staffing, the clinical model and inter-departmental actions and goals. 10% of expected travel within Massachusetts.
If you reside near Worcester, MA, you will enjoy the flexibility to telecommute
- as you take on some tough challenges."
Primary Responsibilities :
Leadership :
Supervises a team that varies in size based upon Capacity Plans and staffing models. Direct reports are located at same site, at home or at a remote UHC siteHires, manages and develops new employees and proactively monitors individual and team performance by providing frequent, ongoing feedback and coachingImplement strategies to improve operational performance, quality and delivery service to constituentsLeads regular team meetings to communicate changes, relevant operational performance information and / or to build employee engagementUtilizes Our United Culture concepts and tools and delivers on the commitmentsDemonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high-performance environmentDrive Effective Clinical Decisions within a Business Environment : Operational Performance :
Develops and / or implements bottoms-up strategies to improve operational performanceContinually stays abreast of operational performance, identifies degradation in service levels and leads to remediation of issuesResponsible for the interview and selection decisions on new hire staffing within their own hierarchyAccountable for a successful new hire onboarding experienceResponsible for creating a positive and meaningful onboarding experience for all employeesDelivers and documents one-on-one coaching to improve all aspects of performance and effectivenessCompletes "side-by-side" monitoring / coaching with direct reports on a regular basisAs needed, prepares, delivers and manages remediation plansParticipate in job fairs, open houses and other recruitment events as neededEnsure compliance with Model of Care and State contractual requirements (Chart audits)Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business resultsUse appropriate business metrics (e.g. member / FTE, length of stay, readmission rates, STAR ratings, member engagement rates) and applicable processes / tools (e.g. cost benefit analysis, return on investment, performance, staffing calculator) to optimize decisions and clinical outcomesPrioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build consensus to triage and deliver work (e.g. assessments, case / claim loads, previous hospitalizations, acuity, morbidity rates, quality of care follow up)Understand and operate effectively / efficiently within legal / regulatory requirements (e.g., HIPAA, CMS, State)Coaching & Performance Management :
Communicate with direct reports on a regular basis through coaching sessions and by providing timely, actionable feedbackEnsures performance metrics and goals are reviewed on a regular and frequent basis, with time set aside for incidental issuesProvides purposeful and actionable development feedback to direct reports and monitors to support their performance improvementIf, after the action items of the development plan do not yield the desired positive results in the agreed upon timeframe, CAP is initiated in accordance with UHG policies and practicesWorks with HRdirect on disciplinary actions or terminations and seeks manager approval on all terminationsTracks and manages attendance and punctuality in a timely and accurate mannerDevelopment & Employee Engagement :
Prepares and delivers thorough and meaningful performance discussions and documents with data and fact-based examples to reduce ambiguity of ongoing expectationsCreates purposeful and actionable development plans, reviews with employees and monitors to support their performance improvement expectations and developmentEngages in regular, meaningful and candid development and career discussions with direct reportsGuides employees to leverage available training and development resourcesAnalyzes and understands Employee experience survey results and communicates results to team membersWorks to establish an action plan to address opportunity areas and improve resultsSupports overall organization in employee engagement programs and communicationsCommunication :
Holds consistent 1 : 1meetings with direct reportsRegularly leverages various communication channels, including one-on-ones and new hire class leadership interactions to foster two-way communication. Inspires employees to see the link between their position and personal performance to organizational strategy, company performance and the UHC brandDemonstrate Business and Industry Knowledge :
Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases)Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid,) or regulatory bodies (e.g., EOHHS, HIPAA, Milliman)Demonstrate understanding of relevant health care benefit plansDemonstrate knowledge of applicable area of clinical specializationUtilize resources to enhance professional practice and development based on learning gaps or new informationYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications :
Unrestricted Nursing license in the state of MA5+ years of care management experience and / or 5+ years of equivalent clinical knowledge and experience such as social care, healthcare coordination, quality improvement1+ years of experience with SharePoint and shared network drivesIntermediate level of proficiency with Microsoft Office applications, including Word, Excel and PowerPointAccess to reliable transportation and valid US driver's licensePreferred Qualifications :
BS / BA Degree3+ years of leadership experienceProven ability to focus activities on a strategic direction and achieve targetsTime management and prioritization skillsStrong written and verbal professional communication skillsExcellent team development skillsStrong interpersonal skillsAbility to work in a self-directed manner in a fast-paced, rapidly changing environmentDemonstrated leadership abilitiesAll Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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