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Job Details

UnitedHealth Group

Home Health Clinical Team Manager - naviHealth - Remote


Home Health


Brentwood, Tennessee, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

The Clinical Team Manager (CTM) is responsible for the day-to-day management and leadership of the remote based home health utilization management team. The CTM is empowered to identify operational performance opportunities, present recommendations for business capabilities and, as applicable, innovate existing UM operations.

This position is part of the Home Health leadership team and utilizes knowledge of commonly used concepts, practices, procedures within authorization services, and business and home health related concepts for management and continuous improvement.

The CTM participates in the hiring and onboarding of new colleagues and the continued clinical development of all colleagues. The position ensures that staff understand and adhere to established clinical protocols and work processes. The position may work with internal and external partners, local leadership, and centralized operational teams to deliver efficient compliant processes that result in a positive member and provider experience.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Manage day to day activities of Care Coordinators as assigned
  • Review and monitor team queue daily
  • Monitor colleague caseloads and performance daily
  • Conduct weekly or monthly team meetings
  • Facilitate weekly 1:1 meeting with assigned colleagues performing both clinical record reviews and offering guidance/support on challenging cases
  • Assist Director with reports and Key Performance Indicators (KPI’s); review key metrics with clinical and market leadership including daily and weekly reporting reviews
  • Hiring process with Clinical management team
  • Function as a preceptor and/or mentor or collaborate closely with a colleague until they can function independently
  • Participate in monthly documentation reviews and provides support/coaching/training to improve performance for colleagues scoring below the acceptable threshold
  • Cultivate a strong internal culture designed around collaboration, feedback, motivation, and accountability
  • Approve PTO requests ensuring adequate staffing is available to meet the needs of the department
  • Review and approve timecards in GSS bi-weekly for payroll
  • Participate/conduct colleague performance reviews
  • Monitor and measure the execution of the naviHealth clinical model with a focus on improving patient outcomes. May recommend process and policy changes based on results from these measures
  • Collaborate with internal business partners/Shared Services area to achieve and maintain all contractual service language agreements
  • Ensure compliance with all federal and state regulations, accreditation organizations, and client requests Collaborates with network colleagues to develop relationships with community providers
  • Complete cross-training and maintain knowledge of multiple contracts/clients to support coverage needs across the business.
  • Perform other duties and responsibilities as required, assigned, or requested.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Active, unrestricted registered clinical license in state of residence – Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
  • 3+ years Geriatric Home Health experience within a residential, assisted living facility, or community through a Medicare Certified Home Health Agency
  • Experience with Oasis
  • Acute Care Experience
  • Proficient with data/dashboard review and Microsoft Office products, including Outlook, Word, Excel, and PowerPoint
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • 5+ years clinical management experience managing multi-disciplinary care teams, including nurses, therapists, social workers, or case managers within the last 10 years
  • Experience working with geriatric population
  • Utilization Management Experience
  • Knowledge of InterQual and Milliman
  • Knowledge of NCQA and URAC standards
  • Proven exceptional verbal and written interpersonal and communication skills
  • Demonstrated independent problem identification/resolution and decision-making skills
  • Proven ability to be detail-oriented
  • Ability to prioritize, plan, and handle multiple tasks/demands simultaneously
  • Demonstrated ability to be a team player

Work Conditions & Physical Requirements:

  • Ability to establish a home office workspace
  • Ability to communicate with clients and team members including use of cellular phone or comparable communication device
  • Ability to remain stationary for extended time periods (1 - 2 hours)

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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.(sm)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All Telecommuters 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.