Manager, Care Management – Remote in Colorado

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

 
Enhances business performance by working collaboratively with the Director and Medical Directors to establish, define, and then manage a comprehensive case management program. Provides oversight of the unit’s functions and performance. Utilizes a broad knowledge of case management to plan, direct and manage the case management program. Responsible for evaluation and resolution of problems and outcomes.

If you reside in the state of Colorado, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities: 

• Oversee the assigned operations of the Care Management Department. Direct full day-to-day oversight and decision making of the Care Management Department, including management of personnel resources, inventory, workflow assessments and evaluation. Appropriately utilize and coach supervisors and team leads. Take corrective action as necessary on a timely basis and in accordance with company policy. Consults with HR as appropriate. Proactive in working with other departments that impact Claims to ensure their work is fully integrated. Identify and resolve any issues that may result in work not being fully integrated. Provide a vehicle for on-going communications
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
• Work collaboratively with the Director and Medical Directors to establish, define, and then manage a comprehensive concurrent review program. Conducts all duties in accordance with the Mission and Values of the company to maintain and enhance RMHP’s reputation as the leader in managed health care. Provide leadership by example to foster the organizational philosophy and culture
• Provide oversight of the case management program
• Is proactive in working with other departments that impact CM to ensure work is fully integrated. Identify and resolve any issues that may result in work not being fully integrated. Provide a vehicle for on-going communications
• Accept responsibility for results of the department with the authority to modify processes in accordance with corporate goals. Implement process changes, new services or other modifications based on results of market research, availability of new technologies, and/or other input
• Collaborate with the Director and others to develop and implement tactical plans (12-18 month duration) for process improvement, problem identification, resolution, detailing goals, critical indicators, measures, financial and other resource requirements related to the CM Department
• Provide oversight for regulatory site visits and audits for all medical management department functions. Identifies areas for improvement and develops action plans to correct deficiencies
• Work with Director to develop new policies and procedures in accordance with legislation. Develop and implement training programs for all CM staff to ensure compliance with all regulations
• Work with Director to update medical management policies and procedures and to update the annual CM Work Plan and Program Description
• Collaborate with the director to prepare the annual budget. Establish guidelines to stay within the specified limits of that budget, contributing to cost-effective operation of the company. Provide monthly review of expenditures and budget allocations
• This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent’s expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage

  
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: 

• Bachelor’s degree in nursing, healthcare management, related healthcare field, or the combination of education and experience in the managed care industry that would enable performance of the full scope of the position
• 5+ years related progressive experience
• 3+ years of management experience
• Driver’s License and access to a reliable transportation
• Resident of Colorado 

Preferred Qualification: 

• CCM certification

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

The salary range for this role is $89,800 to $176,700 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.    
 
  
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.