Clinical Manager RN, STAR+PLUS - El Paso, TX - Remote

UnitedHealth Group•El Paso, TX

11h•$91,700 - $163,700•Remote

About The Position

The Service Coordination Manager, RN provides oversight and direction to the service coordination staff, as well as identify process improvements. The Service Coordinator Manager will lead the way in developing, implementing policies and procedures as necessary to ensure timeliness and accurate delivery of non-waiver and waiver services to achieve optimal outcomes for Star+Plus members. If you live within a commutable distance of El Paso, TX, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

Graduate of an accredited school of nursing
Current unrestricted RN license in Texas
7+ years of experience in healthcare with 2+ years of experience in managed care
3+ years of management or supervisory experience in managed care
Hands-on experience with STAR+PLUS and LTSS program operations and service delivery
Experience with electronic charting and review
Proficiency in a Windows based environment including Microsoft applications such as Word, Excel, and Outlook
Fluent in both English and Spanish language (written and verbal)
Ability to travel locally up to 40%25 of the time
Driver’s license and access to reliable transportation with a valid driver’s license and a good driving record
Able to apply highly technical principles, concepts, and techniques central to the nursing profession in the case management process; specifically with complex populations and waiver
Must have excellent written and verbal communication skills, impeccable negotiating skills, ability to interact with a wide variety of individuals, and handle several complex situations simultaneously
Must have evidence of leadership, creativity, integrity and initiative, and sound problem-solving skills
Must provide attention to detail and follow up
Analytical decision making and judgment skills
Demonstrated ability to function as a clinical care team leader

Nice To Haves

Bachelor’s Degree
CCM and Rug Certification
10+ years of managed health care experience
4+ years of experience working with Medicaid Waiver populations
Experience in managing, evaluating, and composing operational reports
Field-based work experience
Star+Plus management/supervisory experience (operational and process improvement)

Responsibilities

Provide supervision and oversight of service coordination staff
Participate in interdepartmental meetings to represent service coordination needs, including but not limited to: utilization management, provider relations, operations, finance, quality improvement and member services
Facilitate orientation and training of service coordination staff and provides appropriate feedback and evaluation of progress
Establish goals for performance standards of service coordinator
Provide ongoing training and development of service coordination staff to achieve performance standards
Identify problems / barriers / opportunities for intervention. Provides resolution and revision of plans on an ongoing basis
Provide analysis and reporting to ensure compliance with HHSC, TDI, UMCC and URAC standards
Manage field staff productivity goals, member satisfaction and outcomes measures
Conduct ride-along and telephonic auditing to support a part of staff evaluation and monitoring
Develop and maintain corrective action plans as identified