Optum Home & Community Care, part of the UnitedHealth Group 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 members access and navigate care anytime and anywhere.
As a team member of our Optum at Home product, together with an interdisciplinary care team we help members navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.
We're connecting care to create a seamless health journey for members across care settings. Join us to start Caring. Connecting. Growing together.
The Dual Special Needs Plan (DSNP) Optum at Home program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of members in their place of residence. The DSNP program combines Optum trained clinicians providing intensive interventions customized to the needs of each individual, in collaboration with the Interdisciplinary Care Team, which includes the Optum clinician, the member's Primary Care Provider and other providers, and other professionals. Optum providers serve people in their own homes through annual evaluations, ongoing visits for higher risk members, care coordination during transitions from the hospital or nursing home and ongoing care management.
The RN Clinical Manager is responsible for overseeing Registered Nurses Case Managers and may include Social Work Case Managers and participating in day-to-day clinical care of members in the Optum at Home clinical program. This position is responsible for clinical outcomes, business operation targets and overseeing the work activities of team of Registered Nurses and Social Work case managers.
If you reside in Washington DC, Maryland, Virginia you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Set team direction, resolve problems, and provide guidance to members of own team
Lead, supervise, and develop members of the DSNP 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
Ensures the 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
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 implementing activities to grow new membership
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:
Current unrestricted RN license in Washington DC
3+ years of related management experience with focus on managing and developing a clinical team, preferably in a home care and/or long term 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
Valid Driver's License and Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Willing or ability to up to 25-50% travel within Washington DC
Must live within 50 miles for Washington DC
Preferred Qualifications:
BSN
Certified Case Manager Certification (CCM)
Knowledge of Medicare Dual (DSNP) and Medicaid environment
Knowledge of Long-Term Services and Support (LTSS) and Home and Community Based Services (HCBS)
Knowledge of managing complex medical conditions
Proven solid business acumen including analysis and business planning experience
Proven solid organizational skills and multitasking abilities will be keys to success
Proven solid clinical critical thinking skills
Excellent communication skills and demonstrated ability to foster a culture of clinical excellence and build collaborative relationships
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
