Associate Director RN, Onsite – El Paso, TX

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Travel: 10-25% of the time, around El Paso or within Texas

Primary Responsibilities:

• Oversee the implementation and ongoing execution of the strategic and operational business plans for Optum CCM and STAR+PLUS Service Coordination Program 
• Service Coordination, Case Management, and review processes for long-term services and supports
• Build relationships across all business lines to ensure cohesiveness, and all contractual obligations are met
• Oversight of staffing models/resource and budget management, policies and procedures, and reporting
• Collaborate across multiple business lines to ensure Optum and the health plan objectives are aligned, business strategies are developed and delivered timely, and financial, compliance and quality objectives are met
• Hire, develop, and motivate a high performing team to meet organizational goals and objectives while effectively managing change
• Ensure that processes are aligned with URAC, NCQA, HHSC and all governing bodies
• Oversee and ensure compliance with all applicable Federal and State regulations relevant to the Health Plan and managed programs functions
• Develop and maintain internal departmental auditing tools and processes for proactive monitoring for all relevant quality and compliance performance metrics. 
• Partner effectively with the STAR/CHIP/DSNP Program operations to meet all federal, State and LTSS requirements
• This position shall ensure that Service Coordination and CCM staff are trained, knowledgeable and adhere to the requirements of D-SNP, Texas Medicaid to include STAR, CHIP, HCBS Waivers, guidelines, rules and requirements, CFC (Community First Choice), Money Follows the Person Program, and Nursing Facility standards, etc.
• Promote a clear vision aligned with company values and direction set SMART goals and achievable objective
• Motivate and empower staff to balance member needs while being a good steward of the financial budget. Challenging and motivating the team to engage in best practices in management of caseloads and workloads
• Implements and monitors the business plan and oversees any implementations or business transitions impacting service operations. Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction
• Develop and implement staffing models that are consistent, cost effective, and compliant with contractual obligations. Lead recruitment and operating model development to meet operational growth needs. Foster an environment that supports professional development, mobility, and operational excellence
• Develop, implement, and promote clinical operations strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for
• Community Health Choice strategies, policies, and programs
• Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions). Direct enhancements to business processes, policies, and infrastructure to improve operational efficiencies
• Ability to develop business cases for new staffing investments and work with finance to secure funding when additional staff are warranted
• Ability to develop, evaluate and articulate current status, planning, and strategic initiatives via executive level presentations and able to speak professionally to Executive Level audience
• Ability to successfully develop talent, motivate, drive and lead colleagues in Manager, Supervisory and field level positions
• Ability to interpret State contract and federal requirements to ensure Optum is performing to contract expectations
• Skilled in managing people, conflict resolution, ability to influence success at all levels including non-clinical staff
• Collaborate and partner with HHSC and all regulatory agencies to ensure Optum and client are meeting all obligations and reports are submitted timely
• Partner with Quality and Compliance to ensure URAQ and NCQA standards are met
• Develop and participate in presentations to governing entities.  Participate in internal and external health industry development efforts
• Ability to utilize and analyze data to drive decisions and improvements

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:

• Licensed RN in the state of TX or compact license required; BSN
• 3+ years of experience working in STAR+PLUS/Medicaid Long Term Services & Supports (LTSS), and experience with care management 
• Experience with Waiver and HBCS programs
• Experience with data analysis and data-driven program/performance management.
• Experience with quality assurance/continuing quality improvement processes, program oversight and monitoring
• Experience working with a government program
• Personal Computer, Microsoft Office, Clinical Documentation Platforms, Tableau, Power BI, ServiceNow, QNXT

Preferred Qualifications:

• 5+ years of experience in a Senior Manager, or Director role managing mid to large teams of 75+ employees
• Proven ability to lead and drive high performing teams
• Proven track record of success in State and federal surveys/audits and accreditation status
• Proven track record of success in driving positive program outcomes

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

The salary range for this role is $106,800 to $194,200 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.