Community Care Coordination Program Manager - Remote
Community Care Coordination Program Manager - Remote
UnitedHealthcare
Overland Park, KS
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Clinical Program Managers (CPMs) are responsible for the ongoing administration and management of clinical programs. This includes providing support to clinical teams implementing the program such as development and revision of program policies and processes, training on program requirements, consultation and program performance monitoring. The position may involve direct supervision responsibilities. CPMs may be required to travel occasionally to attend State or health plan onsite meetings.
Schedule: This is for a full-time (40 hours/week). Schedule is Monday through Friday any 8-hour or 10- hour shift to be determined by the hiring manager between the hours of 7am to 6pm Central Standard Time.
Location: Remote in the state of Kansas or within 50 miles of the border
If you reside in KS or within 50 miles of border, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities
- This position will be responsible for overseeing the Health Plan’s Community Care Coordination Program. This position will also assist in providing oversight to HCBS Waiver programs
- Develop and maintain program-specific policies and processes. Regularly review processes to look for CQI opportunities
- Provide training to clinical teams on program requirements
- Provide consultation to clinical teams on the application of program requirements to specific Member situations
- Act as a central point of contact with the State for the assigned program
- Apply program requirements and criteria to evaluate the appropriateness of services in collaboration with the Health Plan CMO and LTSS Medical Director
- Communicate and collaborate with service providers regarding program requirements and criteria
- Participate in quality reviews such as State contract compliance reviews, State performance reviews and NCQA accreditation reviews
- Utilize reporting and data to monitor the effectiveness of programs and lead/participate in quality improvement initiatives
Required Qualifications
- Must possess one of the following:
- Master Level Social Worker
- Bachelor’s degree in one of the following:
- Social Work
- Nursing
- Rehabilitation
- Psychology
- Special Education
- Gerontology
- Related health and human services area
- Current, unrestricted independent licensure as a Registered Nurse in Kansas
- Physical or Occupational Therapist
- 3+ years of Clinical experience
- 1+ years of quality management/quality improvement experience
- Intermediate proficiency with MS Word, Excel (create, edit, save documents) and Outlook (email and calendar management) be able to use multiple web applications
- Ability to travel occasionally to State, health plan and provider meetings
- Reside in the state of Kansas or within 50 miles of the border
- Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
- Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
- Managed Care experience
- Program management or leadership experience
- Experience interacting with health and human service providers
- Proven advanced skills in MS Word, Excel and Outlook
- Strong oral and written communication skills
- Demonstrated effective organizational skills and scheduling skills as observed in day-to-day work
- Excellent customer service skills
- Excellent interpersonal and problem-solving skills
- Attention to detail, as observed in day-to-day work
- Excellent time management and prioritization skills
- Ability to maintain professionalism and a positive service attitude at all times
- Must demonstrate flexibility, ability to follow through on all tasks in a timely fashion, good attention to detail and a willingness to learn
- Solid team player and team building skills
- Able to handle sensitive issues with members and providers in a confidential manner
- Demonstrates initiative in achieving individual, team, and organizational goals and objectives
- Creative problem-solving skills
- 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.
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Seniority level
Mid-Senior level -
Employment type
Full-time -
Job function
Project Management and Information Technology -
Industries
Hospitals and Health Care
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