RN Senior Clinical Policy and Procedures Healthcare Compact Lics

WellMed, part of the Optum family of businesses, is seeking a RN Senior Clinical Policy and Procedures Healthcare to join our team in San Antonio, TX, Atlanta, GA, Charlotte, NC, Appleton WI and Fort Knox, KY. Optum is a clinician-led care organization that is changing the way clinicians work and live. 

As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone. 

At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.  

The Senior Clinical Policy and Procedures Registered Nurse (RN) is responsible for the development and implementation of standard policies, procedures, processes and best practices for clinical operations across the enterprise. This position identifies and collaborates with key stakeholders throughout WellMed, USMD and Optum Florida to ensure policies and procedures meet regulatory and statutory guidelines that govern our business practices and ensure quality assurance. Additionally, this position will develop a network of subject matter experts across the enterprise to coordinate comprehensive review of all proposed policies and procedures prior to submission for final approval by the Clinical Operations Policy and Procedure Committee and Senior Leadership. This role aids in guiding support staff, team workflow and operations. This individual is expected to be self-directed and will be given opportunities to work with less structured, more complex issues and serve as a resource for others.

If you are located in San Antonio, TX, Atlanta, GA, Charlotte, NC, Appleton WI, Fort Knox, KY and have a Compact License, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities:

• Develop and maintain policies, procedures, standing orders, logs, and other related resources for clinical operations across the enterprise
• Maintain a repository to organize the inventory of policies, procedures, standing orders, logs, and other related resources
• Gather information and subject matter expertise in response to customer, regulatory or internal evaluation requests for development or revision of enterprise-wide policies and procedures
• Demonstrate understanding of applicable laws, regulations, mandates and standards and the ability to interpret their applicability in a given situation (e.g., state statutes and administrative
• codes, Professional Boards, OSHA, CDC, and Optum Practice Health and Safety Standards)
• Identify and maintain a network of subject matter experts, key stakeholders and compliance contacts to ensure comprehensive review of policies and procedures prior to final approval
• Independently lead and/or organize policy related committees, working groups and educational opportunities to ensure regulatory, practice health and safety, and best practice compliance standards are met
• Prepare reports, presentations, verbal/written correspondences, policies, communications, procedures, and other required documentation
• Plan, provide guidance and delegate activities for subject matter experts, team members, clinical staff and support staff, as needed, to support policy related functions 
• Act as a key resource for others with less experience
• Perform all other related duties as assigned

In 2011, WellMed partnered with Optum to provide care to patients across Texas and Florida. WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for more than 1 million older adults with over 16,000 doctors’ offices. At WellMed our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors. WellMed has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults. Together, we’re making health care work better for everyone. 

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:

• BSN degree or related field (4+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree)
• Active, unrestricted Registered Nurse (RN) license in the applicable state of employment
• 5+ years of healthcare experience to include experience in a managed care setting, hospital setting and/or physician practice setting
• Solid experience with policy writing, development and implementation
• Experience in mobilizing teams and maintaining motivation to accomplish goals under stringent timelines 
• Proficiency with Microsoft Office applications to include Word, Excel, PowerPoint and Outlook
• Proven excellent written communication and attention to detail skill set
• Proven ability to work with minimal guidance, seeking guidance only on the most complex tasks
• Out of town travel required as deemed necessary by business need

Preferred Qualifications:

• MSN degree or related field
• Proven solid program management, preferably within managed care
• Proven solid background in research

Physical & Mental Requirements:

• Ability to lift up to 25 pounds
• Ability to push or pull heavy objects using up to 10 pounds of force
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to properly drive and operate a company vehicle
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving

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

The salary range for this role is $71,600 to $140,600 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. 

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.