Nurse Manager, Case Management - Washington D.C. - Care at Home

UnitedHealth Group•Washington, DC

8d•Onsite

About The Position

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs — helping patients access and navigate care anytime and anywhere. As a team member of our Optum Care at Home team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. This life-changing work adds a layer of support to improve access to care. We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. The Care at Home (CAH) Dual Special Needs Plan (DSNP) program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of patients (beneficiaries) in their place of residence. The CAH program combines Optum trained clinicians providing intensive interventions customized to the needs of each individual, in collaboration with the Interdisciplinary Care Team, comprised of the Care at Home team of clinicians as well as community-based health care professionals (e.g., PCP, specialists, behavioral health, pharmacy, and other providers). Optum providers serve people in their own homes through annual evaluations, longitudinal visits for higher risk beneficiaries, care coordination during transitions from the hospital or nursing home, and ongoing care management. This position is responsible for clinical outcomes, business operation targets, and overseeing the work activities of the team of Registered Nurses and Behavioral Health Case Managers.

Requirements

Current unrestricted RN (Registered Nurse) license
3+ years of related management experience with focus on managing and developing a clinical team, preferably in a home care and/or geriatric care setting
Proven experience in developing and sustaining internal and external client relationships with healthcare professionals
Proficient computer skills including the ability to document medical information with written and electronic medical records
Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area

Nice To Haves

Solid business acumen including analysis and business planning experience
Knowledge of Medicare Dual (DSNP (Dual special needs plan), Chronic Plans (CSNP), and Medicaid environment
Proven excellent communication skills and demonstrated ability to foster a culture of clinical excellence and build collaborative relationships
Proven solid organizational skills and multitasking abilities will be keys to success
Proven solid clinical critical thinking skills

Responsibilities

Set team direction, resolve problems, and provide guidance to members of their team
Lead, supervise, and develop members of the CAH clinical team
Oversee work activities of other supervisors and staff
Adapt departmental plans and priorities to address business and operational challenges
Influence and/or provide input to forecasting and planning activities
Ensure team meets established performance metrics and performance guarantees
Ensure effective orientation and development for Clinical Staff
Utilize Complex Population Management performance tools that hold the clinical team accountable for market metrics and performance standards
Promote individual development by providing learning and growth opportunities to clinical staff
Communicate needs and issues addressed by clinical staff to local market and corporate leadership as appropriate
Participate in site-specific strategic planning activities
Develop solutions to problems or barriers by partnering with key stakeholders
Provide clinical operations across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating)
Serve as a role model to internal and external partners
Oversee implementation and adoption of clinical and quality initiatives
Ensure team is proficient in the delivery of quality care
Use knowledge of the business and financial goals to determine and communicate clinical priorities
Partner with staff to achieve business goals
Monitor and hold clinical team accountable for Model of Care documentation
Actively engage, coach and drive clinical staff in executing activities that promote new engagement