Primary Responsibilities:Implementation and oversight of all clinical management functions for individuals receiving care management (level one and two) program, including but not limited to: assessment, care coordination, interaction with state agencies and community organizations as related to care plan coordination, participant and caregiver education, and oversight of multi-disciplinary care conferences Implementation and oversight of all program management functions, including but not limited to: compliance with program requirements, rules and regulations, implementation of and management of program policies, procedures and protocols that are aligned with federal and state requirements, with an emphasis on audit readiness Participation in all audit reviews both internally and with external partners Successful candidate may represent the plan at meetings with stakeholders, members and regulators, as requested by leadership Candidate should be comfortable with and have experience with public speaking and conducting meetings Superior Excel and PowerPoint skills Experience working with diverse groups of members, state/federal regulators, and stakeholders Candidate should be a patient advocate, and have tenacity for finding solutions Extensive knowledge of the continuum of care
Required Qualifications:Nebraska Registered Licensed Nurse Must be a Nebraska resident 8+ years of clinical experience in health care clinical settings 5 years of extensive experience in leadership and management Experience managing professional remote personnel At least 5 years of experience in case management, LTSS, TCM IDD or Behavior Health populationsPreferred Qualifications:Certified in case management Master's degree in health related field Previously worked in a managed care sectorCareers 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.
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.