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Director of Care Management - Hybrid - Reside in Tennessee

Company: UnitedHealth Group
Location: Philadelphia
Posted on: November 26, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

Medical Director careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Join us.

The Director of Care Management is responsible for functions in areas such as health services, clinical services, and delivery of clinical care. This position includes functions that are responsible for the management and administration of multiple medical and clinical operations and is accountable for the performance of managers and/or senior-level professional staff. The Director of Care Management will supervise a team of employees as they manage the day-to-day operations of interdisciplinary teams of administrative staff, nurse care managers, Community Health Workers, licensed practical nurses, social workers, and behavioral health advocates as they perform telephonically and face to face outreaches with members. The Director of Care Management will be responsible for engaging and coaching their teams to meet or exceed established productivity and quality metrics. They will work with the health plan leadership and lead the alignment processes, policies, and procedures to ensure consistency across the department.

This is a hybrid position that includes working from home and in the Brentwood, TN office.

If you are located in or around Brentwood, TN, you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities:


  • Work independently to identify priorities, make decisions, and complete work to meet established objectives
  • Lead team responsible for supporting Population Health care management programs
  • Develops and executes strategies for assigned team and programs
  • Directs others to resolve business problems that affect multiple functions or disciplines
  • Develop/oversee/deliver operational or technical training for assigned programs
  • Responsible for individual program ownership and owns the end-to-end process
  • Develop and review policies, procedures, and guidelines for assigned programs
  • Evaluate regulatory changes and determine steps needed to implement in programs
  • Identify and implement business development opportunities to support growth
  • Create and implement a business continuity plan to minimize interruptions to the business
  • Evaluate compliance with Federal, State, and Local
  • Evaluate programs and services against accreditation standards, regulatory and organizational guidelines, and contractual requirements
  • Participate in the internal and external auditing process of assigned programs
  • Develop and communicate performance metrics and expectations
  • Collect and review data to evaluate programs and services
  • Provide coaching and feedback that guides the success of staff and assigned programs
  • Compile and prepare the information needed for state partner and health plan reports
  • Work cross-functionally and coordinate with other leaders and teams
  • Perform other related functions 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.
    Required Qualifications:


    • Current, unrestricted independent licensure as a Registered Nurse in Tennessee
    • 5+ years of health-related clinical experience as a Registered Nurse
    • 5+ years of leadership experience managing people and teams
    • Experience developing and implementing policies, procedures
    • Knowledge of health-care-related terminology, programs, and/or services
    • Resides in the state of Tennessee - commutable to Brentwood, TN
    • Reliable transportation and the ability to travel statewide up to 25% of the time for internal and external partner meetings
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation


      Preferred Qualifications:


      • Bachelor's Degree or higher in a health-related field
      • Behavioral Health experience
      • Managed Care Organization experience
      • Experience with writing and submitting regulatory reports
      • Working knowledge of State rules for program-specific eligibility and requirements
      • Understanding of applicable business departments' operations, drivers, and/or procedures
      • Understanding of relevant federal and state regulatory guidelines
      • Proven track record of solid performance management and developing teams
      • Ability to manage multiple complex concurrent projects


        Soft Skills:


        • Excellent interpersonal and communication skills
        • Reporting skills and solid analytical skills
        • Ability to write clearly and help with word processing when necessary
        • Ability to be flexible and work with ambiguity
        • Ability to self-direct work with solid problem-solving skills
        • Ability to multitask and prioritize
        • Ability to work collaboratively
        • Embrace a growth mindset
        • Highly motivated



          To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment


          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)

          All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy


          Diversity creates a healthier atmosphere: 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.

Keywords: UnitedHealth Group, Philadelphia , Director of Care Management - Hybrid - Reside in Tennessee, Executive , Philadelphia, Pennsylvania

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