Clinical Manager RN, STAR+PLUS - El Paso, TX at UnitedHealth Group

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Service Coordination Manager, RN provides oversight and direction to the service coordination staff, as well as identify process improvements. The Service Coordinator Manager will lead the way in developing, implementing policies and procedures as necessary to ensure timeliness and accurate delivery of non-waiver and waiver services to achieve optimal outcomes for Star+Plus members.Primary Responsibilities:Provide supervision and oversight of service coordination staffParticipate in interdepartmental meetings to represent service coordination needs, including but not limited to: utilization management, provider relations, operations, finance, quality improvement and member servicesFacilitate orientation and training of service coordination staff and provides appropriate feedback and evaluation of progressEstablish goals for performance standards of service coordinatorProvide ongoing training and development of service coordination staff to achieve performance standardsIdentify problems / barriers / opportunities for intervention. Provides resolution and revision of plans on an ongoing basisProvide analysis and reporting to ensure compliance with HHSC, TDI, UMCC and URAC standardsManage field staff productivity goals, member satisfaction and outcomes measuresConduct ride-along and telephonic auditing to support a part of staff evaluation and monitoringDevelop and maintain corrective action plans as identifiedKnowledge and Skills:Able to apply highly technical principles, concepts, and techniques central to the nursing profession in the case management process; specifically with complex populations and waiverMust have excellent written and verbal communication skills, impeccable negotiating skills, ability to interact with a wide variety of individuals, and handle several complex situations simultaneouslyMust have evidence of leadership, creativity, integrity and initiative, and sound problem-solving skillsMust provide attention to detail and follow upAnalytical decision making and judgment skillsDemonstrated ability to function as a clinical care team leaderYou'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.Required Qualifications:Graduate of an accredited school of nursingCurrent unrestricted RN license in Texas7+ years of experience in healthcare with 2+ years of experience in managed care3+ years of management or supervisory experience in managed careHands-on experience with STAR+PLUS and LTSS program operations and service deliveryExperience with electronic charting and reviewProficiency in a Windows based environment including Microsoft applications such as Word, Excel, and OutlookFluent in both English and Spanish language (written and verbal)Ability to travel locally up to 40% of the timeDriver's license and access to reliable transportation with a valid driver's license and a good driving recordPreferred Qualifications:Bachelor's DegreeCCM and Rug Certification10+ years of managed health care experience4+ years of experience working with Medicaid Waiver populationsExperience in managing, evaluating, and composing operational reportsField-based work experienceStar+Plus management/supervisory experience (operational and process improvement)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.