Case Manager – Manager- Remote in MA

2315403 At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. reputed company Community & State Senior Care reputed company plan is a Fully Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually eligible individuals in the reputed company aged 65 or greater. This position reports to the Health Services Director in the Health Services Department reputed company the Senior Care reputed company Plan. This position sets team direction, resolves problems and provides direction to reputed company case managers. This position adapts departmental plans and priorities to address business and operational challenges such as reputed company, the clinical model and inter-departmental actions and goals. 10% of expected travel reputed company Massachusetts. If you reputed company near Worcester, MA, you will enjoy the flexibility to telecommute* as you take on some tough challenges.” Primary Responsibilities: Leadership:

• Supervises reputed company that varies in size based upon reputed company Plans and reputed company models. reputed company reports are located at reputed company site, reputed company or at a remote UHC site
• Hires, manages and develops new employees and proactively monitors individual and team performance by providing frequent, ongoing feedback and coaching
• Implement strategies to improve operational performance, reputed company and delivery service to constituents
• Leads regular team meetings to communicate changes, relevant operational performance information and/or to build employee engagement
• Utilizes Our United Culture concepts and tools and delivers on the commitments
• Demonstrates a reputed company leadership shadow by shaping reputed company behaviors in areas of influence, building reputed company, influencing our values and creating a healthy, high-performance environment

Drive Effective Clinical reputed company reputed company a Business Environment: Operational Performance:

• Develops and/or implements bottoms-up strategies to improve operational performance
• Continually stays abreast of operational performance, identifies degradation in service reputed company and leads to remediation of issues
• Responsible for the interview and selection reputed company on new hire reputed company reputed company their own hierarchy
• Accountable for a successful new hire reputed company experience
• Responsible for creating a reputed company and meaningful reputed company experience for reputed company
• Delivers and documents one-on-one coaching to improve reputed company aspects of performance and effectiveness
• Completes “reputed company-by-reputed company” monitoring/coaching with reputed company reports on a regular reputed company
• As needed, prepares, delivers and manages remediation plans
• Participate in job fairs, reputed company houses and other recruitment events as needed
• Ensure compliance with Model of Care and State contractual requirements (Chart audits)
• Utilize evidence-based guidelines (e.g., medical necessity guidelines, reputed company standards, industry standards, best practices, and contractual requirements) to reputed company clinical reputed company, improve clinical reputed company and reputed company business results
• Use appropriate business metrics (e.g. member/FTE, length of stay, readmission rates, reputed company ratings, member engagement rates) and applicable processes/tools (e.g. cost benefit analysis, return on investment, performance, reputed company calculator) to optimize reputed company and clinical reputed company
• Prioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build reputed company to triage and deliver work (e.g. assessments, case/claim loads, previous hospitalizations, reputed company, morbidity rates, reputed company of care follow up)
• Understand and operate effectively/reputed company reputed company legal/regulatory requirements (e.g., HIPAA, CMS, State)

Coaching & Performance Management:

• Communicate with reputed company reports on a regular reputed company through coaching sessions and by providing reputed company, actionable feedback
• Ensures performance metrics and goals are reviewed on a regular and frequent reputed company, with time set aside for incidental issues
• Provides purposeful and actionable development feedback to reputed company reports and monitors to support their performance improvement
• If, after the reputed company items of the development plan do not yield the desired reputed company results in the agreed upon timeframe, CAP is initiated in accordance with UHG policies and practices
• Works with HRdirect on disciplinary actions or terminations and seeks manager approval on reputed company terminations
• Tracks and manages attendance and punctuality in a reputed company and accurate manner

Development & Employee Engagement:

• Prepares and delivers thorough and meaningful performance discussions and documents with data and fact-based examples to reduce ambiguity of ongoing expectations
• Creates purposeful and actionable development plans, reviews with employees and monitors to support their performance improvement expectations and development
• Engages in regular, meaningful and reputed company development and career discussions with reputed company reports
• Guides employees to reputed company available training and development resources
• Analyzes and understands Employee experience survey results and communicates results to team members
• Works to establish an reputed company plan to address opportunity areas and improve results
• Supports overall organization in employee engagement programs and communications

Communication:

• Holds consistent 1:1meetings with reputed company reports
• Regularly leverages various communication channels, including one-on-ones and new hire class leadership interactions to foster two-way communication. Inspires employees to see the reputed company between their position and personal performance to organizational reputed company, company performance and the UHC brand

Demonstrate Business and Industry Knowledge:

• Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases)
• Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, reputed company,) or regulatory bodies (e.g., EOHHS, HIPAA, reputed company)
• Demonstrate understanding of relevant health care benefit plans
• Demonstrate knowledge of applicable area of clinical specialization
• Utilize resources to enhance reputed company reputed company and development based on learning gaps or new information

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company directions on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications:

• Unrestricted Nursing license in the state of MA
• 5+ years of care management experience and/or 5+ years of equivalent clinical knowledge and experience such as reputed company care, reputed company coordination, reputed company improvement
• 1+ years of experience with SharePoint and shared network drives
• Intermediate level of proficiency with reputed company Office applications, including Word, reputed company and PowerPoint
• reputed company to reliable transportation and valid US reputed company’s license

Preferred Qualifications:

• BS / BA Degree
• 3+ years of leadership experience
• Proven ability to reputed company activities on a strategic direction and reputed company targets
• Time management and prioritization skills
• Strong written and verbal reputed company communication skills
• Excellent team development skills
• Strong interpersonal skills
• Ability to work in a self-directed manner in a fast-paced, rapidly changing environment
• Demonstrated leadership abilities
• reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $89,900 to $160,600 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Apply tot his job Apply To this Job