At Optum, 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! 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) As a part of our continued growth, we are searching for a new Associate Director of Medical Management to join our team! The Associate Director of Medical Management is located within Care Delivery Organization office and works closely with the Chief Medical Officer, Medical Directors and leaders of Utilization Management and Case Management including Social Workers, Nurses and clinical Administrative staff. This role will closely support and assist the VP of Medical Management Operations. Additional responsibilities include the development of initiatives within the Maricopa county market, building relationships with community leaders, working closely with Managers of Complex Case Management and Utilization Review along with building Regional Clinical Best Practice Standards. The Associate Director will also work directly with our care delivery partners on meeting and exceeding our Affordability goals. Primary Responsibilities:Clinical operations across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating) Adapts departmental plans and priorities to address business and operational challenges Takes a key role in setting direction and participating in or developing new programs Responsible for working closely with trainers to initiate procedures and audits necessary for national Accreditation for Complex Case Management and in the future UM and DM The Associate Director works collaboratively with the members, providers, PCP Network, and other departments to maximize member's benefits within a cost effective environment Identify compliance and quality improvement opportunities and collaborates with Quality area Assist in implementing procedures to provide excellent customer service to our clients through but not limited to communication, staffing, phone availability and service execution Responsible for reports including identifying areas of concern and suggesting how to track and trend the outcomes along with regulatory oversight Participate in onsite meetings and JOCs with Facility Leadership and Providers to discuss current CM trends and how to improve patient outcomes
Required Qualifications:Current and unrestricted RN license in the State of Arizona 5 or more years of Case Management/UM experience 5 or more years of Leadership/Management experience 5 or more years of clinical nursing experience Ability to obtain CCM within 2 years Excellent written and verbal communication skillsPreferred Qualifications:Medicare and Managed Care work experience SNF environment experience Current Certified Case Manager (CCM) Master's Degree in Nursing or health related field Background in NCQA Accreditation for Complex Case Management Careers with Optum. 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. Optum, 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. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SMDiversity 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. Job Keywords: Managed care, medical management, RN, Associate Director, Medicare, Medicare Advantage, Case Management, CCM, Phoenix, AZ, Arizona
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.