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 patients access and navigate care anytime and anywhere.

As a team member of our naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home.

We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

Why naviHealth?

At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy.

The Clinical Team Manager (CTM) is responsible for the day-to-day management and leadership of the Skilled Inpatient Care Coordinators. The CTM, collaborating with the DCO 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 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.

If you are able to commute to site specific facilities in South Carolina, you'll enjoy the flexibility to work from home and the office in this hybrid role* as you take on some tough challenges.

Primary Responsibilities:

• Manage day to day activities of Care Coordinators as assigned
• Monitor colleague caseloads daily
• Approve PTO requests ensuring adequate staffing is available to meet the needs of the department
• Review and approve timecards in ADP bi-weekly for payroll
• Review and monitor team queue daily
• Cultivate a solid internal culture designed around collaboration, feedback, motivation, and accountability
• Hiring process with Clinical management team
• Participate/conduct colleague performance reviews
• Function as a preceptor and/or mentor or collaborate closely with a colleague until they can function independently
• Review key metrics with clinical and market leadership including daily and weekly reporting reviews
• Participate in monthly documentation reviews and provides support/coaching/training to improve performance for colleagues scoring below the acceptable threshold
• Monitor and measure the execution of the naviHealth clinical model with a focus on improving patient outcomes. May recommend process and policy changes to leadership based on results from these measures
• 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
• Meet with and review colleague performance via observations at set intervals, as determined by the market, but no less than quarterly
• 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
• Perform other duties and responsibilities as required, assigned, or requested, including assisting DCO with reports and KPI's
• Collaborates with network colleagues to develop relationships with community providers

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 - Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
• 3+ years of clinical experience as a Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
• 1+ years of clinical management/leadership experience
• Experience implementing CMS guidelines/regulations
• Advanced experience with MS Office (Excel, Word, PowerPoint, Outlook)
• Experience in writing clear, comprehensive, accurate, and appropriate communications
• Availability to travel to Charleston and Myrtle Beach, SC for management meetings and SICC onsite visits up to 50% of the time
• Dedicated, distraction-free space in home for home office
• Access to high-speed internet from home (Broadband Cable, DSL, Fiber)
• Availability 8a-5p EST

Preferred Qualifications:

• 1+ years of clinical management in Skilled Nursing utilizing Medicare advantage
• Experience managing multi-disciplinary care teams, including nurses, therapists, social workers, or case managers
• Experience completing quality audits and/or reviewing/assessing for quality components
• Experience coaching, mentoring, and educating
• Experience working with geriatric population
• Knowledge of InterQual and Milliman
• Knowledge of NCQA and URAC standards
• Experience prioritizing, planning, and managing multiple tasks/demands simultaneously

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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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