Manager Clinical Operations Tacoma, Washington
Location: Tacoma Washington
Description: UnitedHealth Group is employing Manager Clinical Operations Tacoma, Washington right now, this vacancy will be placed in Washington. For detail informations about this vacancy opportunity kindly see the descriptions. 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)
Overall responsibility for the Manager of Clinical Operations is for utilization management and care management, including day-to-day oversight and supervision of Care Managers and Discharge Coordinators, clinical training and staff orientation, risk management, an! d working with the Deputy Director and Medical Director to ens! ure implementation of the Utilization Management Plan. This position will serve as the primary point of contact for Medical Health Plans and primary care providers and will also provide clinical backup and perform the Care Manager duties as needed. He/she will also work closely with the Information Technology Unit, Quality Assurance/Performance Improvement (QA/PI) Unit, Recovery & Resiliency Unit, and Provider Relations Unit as well as contractors, provider agencies, and other community stakeholders. Work assignments are received with little or no technical instruction and require the selection of course of action and resolution of complex or unique problems with considerable latitude for independent judgment to develop procedures and systems.
***This is a office position located at 3315 S 23rd Street Tacoma, Washington; this position will also include 40% travel into the community.***
Responsibilities: 1. Provides clinical direction, administration and ! leadership for the Care Management Program including supervision of Care Managers, Discharge Coordinators and management of day-to-day operations.2. Responsible for the implementation of Clinical Practice Guidelines and auditing records to determine compliance with them.3. Monitors the performance of care management staff to ensure standards and targets are being met using call observation and silent call monitoring, inter-rater reliability testing, analysis of aggregate data, chart and online audits, and review of the quality and accuracy of information provided to callers. 4. Maintains master schedule of care management staff to ensure availability for all necessary customer service functions, provider meetings, and out-of-office work related meetings. 5. Facilitates daily clinical unit meetings and attends bi-weekly case review meetings with the Medical Director and all care management staff as part of the supervisory process and also to help ensure appropriate person-ce! ntered treatment and support resources for consumers. 6. Along with the! Deputy Director, co-chairs a monthly High Risk meeting where utilization data will be presented and analyzed to detect any concerning trends or patterns and take necessary action. 7. Works with QA/PI Manager to assure that quality standards and processes are integrated into the Care Management Unit.8. Has a leadership role in the Utilization Management Committee and integrates overall utilization management activities into the Care Management function.9. Works closely with Information Technology Unit to determine and capture data related to clinical outcomes.10. Provides overall project management for the development and revision of policies and procedures. Writes all Care Management policies and procedures and provides subject matter consultation for all policies and procedures that indirectly impact the Care Management function.11. Represents OptumHealth Pierce in various administrative meetings with the Mental Health Division and other entities involved in the provision! and monitoring of services.12. Maintains knowledge of current legislation and State and Federal administrative codes and assures that Care Management functions comply with all regulations.13. Prepares and/or monitors preparation of documentation required for clinical reviews and on-site audits.14. Works collaboratively with the Medical Health Plans that serve Pierce Medicaid Healthy Options beneficiaries including providing clinical consultation, establishing referral protocols, consistent application of Access to Care criteria. 1. Master's degree in an appropriate Behavioral Health field, Doctoral degree preferred.2. Requires a current, unrestricted professional Social Worker, Psychology, Mental Health, Registered Nurse (RN) or Nurse Practitioner (NP) license
3. Must be licensed and registered as a Mental Health Professional in the State of Washington (or have ability to obtain a license within one year of hire). 4. Five years experience with at least 3 years of ! applied clinical experience5. Two years of administrative management ex! perience
6. One year of Utilization Review and Managed Care experience. 7. Experience as a clinician or Care Manager in a delivery system that follows the principles of recovery and resiliency is strongly preferred. 8. Knowledge of principles and practices of public and commercial mental health service delivery systems.9. Demonstrated competence in clinical care management, strong leadership and organization skills; interpretation of County, State and federal laws and regulations relevant to the mental health program area.10. Knowledge of evidence based, best and promising practice methods and procedures and strong customer service orientation. 11. Ability to effectively plan, assign, direct and evaluate the work of people the position manages.12. Ability to interpret and analyze data.13. Understanding of principled leadership. 14. Excellent verbal, written, and interpersonal communication skills.15. Computer proficiency including Microsoft applications required. OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUni! tedHealth Group is a drug-free workplace. Candidates are required to pa! ss a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Key Words: Social Workers, Psychology, Mental Health, RN, NP, Manager, Management, leadership, Operations, Utilization Management, Tacoma, Washington
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
If you interested on this vacancy just click on the Apply button, you will be redirected to the official website
This vacancy starts available on: Wed, 27 Nov 2013 18:24:50 GMT
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