HSS Manager, Hamilton and Bradley Counties - Remote in TN

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United HealthGroup Community, CHOICES program offers person-centered care planning, service coordination and support services for members receiving long-term care (LTC) and home and community (HCBS) services. The Manager of Care Management (MCM) is responsible for providing oversight of long-term care (LTC) and home and community based (HCBS) services. The care coordination team facilitates, promotes and advocates for the member’s ongoing self-sufficiency and independence.

Additionally, the care coordination team is responsible for sustaining the natural supports of the member. This includes... but is not limited to assessing the availability of natural supports, representative or family members to ensure the ongoing mental and physical health of those natural supports.

40 - 60% local travel is required in this position.

10 - 15% statewide travel is required in this position

If you are located in or within commutable driving distance to Hamilton and Brandley Counties in Tennessee, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities
• Supervise, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordinators activities, which include, but are not limited to , routinely assessing and monitoring members’ status, needs and progress; developing individual plans of care for members; managing critical transitions, coordinating appropriate treatments and services, identifying and communicating opportunities for care intervention; authorizing care services; monitoring and ensuring the provision of covered services as a cost-effective alternative; developing and implementing targeted strategies to improve health, functional and quality of life outcomes; proactively educating members; conducting, reviewing and revising member’s risk assessments and risk agreement; maintaining appropriate and ongoing communications and collaborations with members, their authorized representative and providers; and reporting quantifiable impact, quality of care and quality of life improvements as measured against care coordination goals
• Interviewing, hiring, disciplining, evaluating and mentoring a diverse care coordination work force
• Primary responsibility for onboarding new staff including but not limited all pre-employment human resource tasks, ordering of software, hardware, supplies and support technologies
• Active participation in the preceptorship of new CHOICES clinical staff, providing the level and degree of support needed to ensure that newly assigned CC’s are competent in the Care Coordination process
• Primary responsibility to develop and initiate new employee orientation core curriculums and obtain complete sign-off of orientation tasks list prior to assignment of permanent caseload
• Responsible for conducting all relevant activities related to exiting clinical staff to ensure that all Company assets (computers, printers, cell phones, Air Cards, and other related equipment) are retrieved in accordance with company policies
• Under the supervision of the Health Services Director (HSD), provide and/or coordinate staff training for maximum performance and provide developmental opportunities
• Promote teamwork and a positive working environment for the care coordinators
• Responsible for communication and mentoring members of the care coordination team to ensure long-term and home and community base d care guidelines, policies and procedures are followed
• Monitor performance of staff including service performance and adherence to establish utilization and care coordination benchmarks
• In collaboration with the HSD will create and monitor development plans for direct reports who need additional coaching in performance area
• Will develop and implement, in collaboration with the HDS Corrective Action Plans for those direct reports who are not meeting performance expectations
• MCM’s will support those direct reports with performance issues through coaching in the development and implementation of formal Develop Plans for each direct report and Corrective Action Plans when performance warrants
• Actively participate in the MAP process, developing annual MAP goal, in collaboration with HSD’s for direct reports and monitoring progress on a regular basis
• May be required periodically to staff a case load of members, when dictated by census fluctuation or staffing coverage
• Performs comprehensive member assessment, develops plan of care, risk assessment and all necessary enrollment documents within contractual compliance and provides primary technical support/assistance to subordinates for these job functions
• Ensures contract compliance for new member outreach, initiation of services, visit compliance, initial, monthly, quarterly and/or annually
• Develop and implement coaching plans for employees falling below 90% visit compliance and/or 100% initiation of services to ensure that employee comes within compliance within one month
• Will report to HSD during weekly 1:1 on employees out of compliance and/or strategies and plans to ensure employees compliance
• Responsible to ensure 100% initiation of service compliance
• Responsible to lead collaborative CMA ORR calls related to initiation of services
• Develops and maintains an intermediate to advanced functioning in CareOne, Word, Excel, Outlook, Visio and other applicable software platforms
• Serves as team’s primary support for technologies, including but not limited to PC/laptop, air care, cell phone, etc.
• Performs ride along visits with each assigned staff member to observe assigned employee’s performance, as appropriate to manager the employee
• Other duties deemed necessary for effective and efficient team operations

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
• Registered Nurse with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse License Compact Law OR a Social Worker with active license in the state of Tennessee (LCSW, LBSW)
• 3+ years supervisory/management experience (direct supervision, team lead, SME, preceptor)
• 2+ years of relevant health care experience, preferably in managed and/or long-term care
• Intermediate to advanced software application and hardware expertise
• Ability to work within highly structure contractual time compliance requirements with occasional short turn-around times
• Demonstrated ability to work effectively in vertically-matrix organizations
• Reliable transportation and the ability to travel up to 25% within a designated area

Preferred Qualifications
• Master level Social Worker with active license in the state of Tennessee (LMSW or LAPSW)
• 3+ years of experience providing care coordination to persons receiving long-term care and/or home and community based services
• Advanced skills of critical thinking, follow through, independent self-starter, fully integrated team member, organization, written and verbal communication, computer-literate, problem-solving, professional acumen, human relation skills and analytical skills
• 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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