1+ months

RN Manager Care Management Fort Worth TX 5000 SIGN ON BONUS for External Candidates

Fort Worth, TX 76102
  • Job Code
    871440



$5,000 Sign-on bonus for external candidates!

 



This position is based out of the Fort Worth office and not a telecommute role.

   

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)

   

The Manager of Case Management is responsible for facilitating communication and directing the operations of all Case Management programs in a defined market.  The Manager leads the market staff on all activities related to medical management initiatives including changes in process, staffing or care delivery model. Additionally, the manager ensures compliance with all state / federal regulations and NCQA / URAC standards.  The Manager collaborates with the Regional Director of Case Management, medical directors, PCPs, clinic and corporate medical management leadership on care coordination activities.

  
Primary Responsibilities: 
  • Supports case management operations across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating)
  • Oversees care management functions and ensure compliance with application of criteria from approved standardized guidelines, government mandated regulations and contractual agreements, to include NCAQ, URAC, and CMS
  • Engages in Care Team forums / meetings¬† to support care coordination activities between the market providers and the case management team
  • Plans, organizes and oversees staff to ensure timely completion of um determinations, discharge planning and case management assessments
  • Ensures team meets established performance metrics and medical cost reduction goals. Includes timely reporting of monthly KPIs
  • Adapts departmental plans and priorities to address business and operational challenges
  • Oversees the team's daily staffing requirements to meet program standards
  • Implements and interprets organizational policies and procedures, reviews work of staff to ensure that policies and guidelines are appropriately applied
  • Tracks and trends outcomes for potential improvements in the care management process.¬† Creates monitors, evaluates and disseminates program and productivity reports weekly, monthly, and as needed
  • Interviews, hires, and retains staff to meet the needs of the department
  • Evaluates staff performance and recommend merit increases, promotions, and disciplinary actions
  • Attends, and assists with the facilitation of local market¬† intra-disciplinary care team meetings
  • Monitors and oversees the reporting of all quality issues to medical management leadership for referral and reporting to health plans as appropriate
  • Monitors appropriate utilization of resources, overtime, supplies and mileage
  • Perform comprehensive assessments and document findings in a concise / comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations
  • Performs all other related duties as assigned

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.

",

Categories

Posted: 2020-04-30 Expires: 2020-06-28

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

RN Manager Care Management Fort Worth TX 5000 SIGN ON BONUS for External Candidates

UnitedHealth Group
Fort Worth, TX 76102

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast