AmeriChoice 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.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
As the Manager of Care Management, you will:
- Carry out supervisory responsibilities in accordance with the organization's policies and applicable laws.
- Perform supervisory audits as necessary.
- Maintain overall responsibility for the supervision and coordination of all workflow activities related to Utilization Management & Case Management activities for designated team.
- Provide clinical expertise to the nursing team and support staff.
- Provide support with UM/CM teams' activities as necessary.
- Provide mentorship and training for team members
- Represent the department in assigned Plan committees/meetings.
- Assist with all team member Human Resource activities.
- Support excellent employee performance and encourage staff development.
- Assist with the development and implementation of departmental policies and procedures.
- Conduct weekly meetings to review complex cases and changes in procedures.
- Prepare and submit activity reports as required.
- Complete special projects and tasks as assigned.
- Manage the multiple roles within the ICCT (Integrated Care Coordination Team).
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Qualifications
- Clinical Registered Nurse with current, unrestricted licensure required
- 2+ years working in Medicaid and/or Medicare health care and insurance industry, including regulatory and compliance requirements
- 4+ years demonstrated leadership and team management/development skills
- 8+ years Clinical background preferred
- Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets
- Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
- Solid experience with Case Management
- Solid experience with Utilization Management
- Knowledge/understanding of Interqual and/or Milliman Guidelines
- Bachelors degree in Science or equivalent work experience required; Masters degree preferred
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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