- Computer Literacy
- Management Experience
- Microsoft Word
- Microsoft Office
- Microsoft Access
OVERVIEW OF POSITION:
Responsible for overseeing the management and optimization of centrally based CM departments and functions. Oversight includes: Transplant, Out-of-Area, Inpatient Central and Triage Nursing Division. Develops and implements procedures in coordination with the Regions for transfer of care processes between the inpatient and ambulatory care settings. Also acts as liaison with company wide contracted entities such as Home Health and DME vendors. Acts to support the contracting department as the clinical subject matter expert in ancillary contract negotiations.
Oversees and supports CM Central departments: Transplant, Out-of-Area, Inpatient Central and Triage Nursing Division.
Develops reports and metrics to be used for productivity, adherence, and outcome measurements.
Monitors and performs analysis of metrics associated with these departments.
Ensures departments optimize workflow efficiencies to meet company objectives.
Provide supervision, guidance, and mentoring to managers and staff reporting to this position.
Identifies opportunities that these departments can implement to support financial goals of organization.
Acts as subject matter expert to contracting department in negotiation of ancillary contracts.
Ensures that service standards are implemented and adhered to by company-wide vendors (e.g., home health, DME).
Leads and/or participates in company-wide assigned projects that deal with CM/UM processes.
Coordinates and supports roll out of CM processes to the Regions in cooperation with the Vice Presidents, Regional Care Management.
Act as Regional support to CM in areas of benefit interpretation, injectable process, vendor compliance, and CM process flow issues.
Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college.
Graduate from an accredited school of Nursing.
Current California RN license.
Over 7 years and up to and including 10 years of experience.
5 years management experience, preferably in a medical group / IPA, or HMO setting.
Experience in Managed Care.
KNOWLEDGE, SKILLS, ABILITIES:
Proficient in Microsoft applications (Word, Excel, PowerPoint, Access).
Excellent verbal and written communication skills.
What's the first thing that happens when one of the leading independent medical groups in the country comes together with a global leader in health care? Opportunity. With DaVita Medical Group, HealthCare Partners, The Everett Clinic, Northwest Physicians Network, MountainView Medical Group and Magan Medical Clinic joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. We're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity to do your life's best work.(SM)
Careers with OptumCare. Here's the idea. We built an entire organization around one giant objective; make the health system 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. OptumCare, 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. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)
Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers 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. OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.