There is energy and excitement here, a shared mission to improve the lives of others as well as our own. A passion for excellence you will not find anywhere else. We ask tough questions. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Nursing here is not for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Are you ready for a new path? Learn more, and start doing your life's best work.(sm) What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you will open doors for yourself that simply do not exist in any other organization, anywhere. The Clinical Integrated Care Manager is responsible to coordinate services for pediatric/adult members with identified high-risk medical and behavioral health needs. Perform Case Management (CM) activities to include assessment planning, service implementation, care coordination, monitoring and evaluating the plan of care for high-risk members. Clinical programs support coordinator. This is an office-based position located at 1 East Washington Street, Phoenix, AZ. Primary Responsibilities:Carries out responsibilities in accordance with the organization's policies and regulatory requirements Serve as a liaison between Health Services Unit and the Business Partners Perform Case Management activities to include: assessment planning, service implementation, care coordination, monitoring and evaluation and plan of care development Track and report member milestones monthly and provide status updates quarterly Review, Analyze and Prepare assigned regulatory reports as required Provide education and training for business partners and team members Represents the department in assigned Plan committees / meetings Coordinates Clinical Functions with the UHC Community Plan programs Drive continuous program improvement projects Assist with the development and updates of policies and procedures Problem solve skills: the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action Excellent verbal communication and business technical writing skills; ability to speak clearly and concisely, convey complex or technical information in a manner that others can understand Results-oriented, self-starter with ability to learn quickly, adapt to changing priorities and multi-task
Required Qualifications: Current, unrestricted RN license in the State of Arizona 5+ years clinical, pediatric / adult and case management experience Ability to prepare written responses for regulatory submissions Intermediate level of experience with Microsoft Word and Excel, with the ability to navigate a Windows environmentPreferred Qualifications: A background in managed care A background working with the AZ Regional Behavioral Health Authorities Medicare / Medicaid experience Experience presenting to groups and key stakeholders Experience in project managementCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) 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. Job Keywords: RN, Registered Nurse, Case Manager, Care Manager, Managed Care, Medicaid, Medicare, Pediatric, Adult, RBHA, behavioral health, Phoenix, AZ, Arizona
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.