For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
In the Health and Social Services Manager role, you will lead a team of Health and Social Services Coordinators, while overseeing day-to-day clinical operations and participating in business development activities. You will manage a program or region, including team and performance management, process improvement, and standardized execution of clinical decision processes, and implementation of new program initiatives. Complying with contractual requirements and ensuring member needs are met.
If you are located in Iselin, New Jersey, you will have the flexibility to telecommute* as you take on some tough challenges.
Selects, manages, develops, mentors and supports staff in designated department or region.
Develops clear goals and objectives for performance management and effectively communicates expectations, and holds the team accountable for results.
In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements.
Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements.
Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence.
Acts as regional interface with other departments to coordinate workflow processes and implementation plans
Manages the day-to-day operations for nursing facility and assisted living care managers in 10 southern counties, which included resolving problems, providing guidance and coaching members of the team to ensure the team meets the established performance metrics
Oversee interdisciplinary teams for Nursing Facility transitions.
Resolves inpatient and outpatient provider authorizations and collaborate with Provider relations to assist in Provider resolutions.
Participates in training and coaching of direct reports as needed
Conducts bi-annual field visits with direct reports to observe, provide areas of teaching, address issues and concerns and foster a good working relationship
Collaborates across Optum and UHG and interacted with Medical Directors, Site Directors, Senior Leaders, Network, Marketing, Account Management, Quality, Product, and other stakeholders
Serves as a direct liasion for members, nursing facility providers and assisted living providers and nursing facility transition programs (I Choose home New Jersey)
Review and desimanate report inpatient census report for NF case
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.
5+ years of experience working within the community health setting in a health care role
Experience coaching or mentoring staff
Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment
Registered Nurse, licensed social worker and/or behavioral health or clinical degree – STRONGLY preferred
3+ year of case management leadership experience within a healthcare industry
Spanish Strongly Preferred
A background in managed care
Case Management experience
Certified Case Manager (CCM)
Experience/exposure with discharge planning
Experience in utilization review, concurrent review and/or risk management
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)
Diversity creates a healthier atmosphere:
- All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.