Manager Case Management

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.    

The Manager, Case Management, is responsible for the overall leadership, operations, and performance of the Care Management Department. This role provides strategic and operational oversight to ensure delivery of high-quality, patient-centered care across the continuum. The Manager leads interdisciplinary collaboration, drives regulatory compliance, and ensures alignment with organizational goals related to patient flow, length of stay, and discharge planning.

The Manager is accountable for departmental outcomes, staff performance, program development, and continuous improvement initiatives while fostering a culture of accountability, engagement, and professional excellence.

Primary Responsibilities:  

• Operational & Clinical Leadership
  • Provides leadership and oversight of daily operations and long-term strategic direction for the Care Management Department
  • Develops, implements, and evaluates operational plans to achieve departmental and organizational objectives
  • Ensures effective coordination of care across the continuum through interdisciplinary collaboration
  • Leads process improvement initiatives to optimize patient throughput, reduce length of stay, and improve care transitions
  • Identifies, evaluates, and resolves complex operational and clinical issues
  • Ensures delivery of quality care in accordance with regulatory requirements, hospital policies, and professional standards
• Staffing, Scheduling & Performance Management
  • Oversees staffing models, scheduling processes, and resource allocation to meet operational demands
  • Leads recruitment, hiring, onboarding, and retention strategies for Care Management staff
  • Provides coaching, performance management, and accountability for assigned team members
  • Establishes clear performance expectations and conducts routine performance evaluations
  • Fosters a culture of engagement, collaboration, and professional development
• Clinical Oversight & Education
  • Serves as a subject matter expert for Care Management practices
  • Promotes evidence-based practice, clinical excellence, and ongoing professional development
  • Ensures staff competency and compliance with regulatory standards
• Quality, Safety & Compliance
  • Ensures departmental compliance with CMS, regulatory, and accreditation requirements
  • Oversees quality monitoring activities, audits, and performance improvement initiatives
  • Reviews, investigates, and resolves incidents, safety concerns, and risk events
  • Promotes a culture of safety, accountability, and non-punitive reporting
  • Monitors key performance indicators, including length of stay, avoidable days, and throughput metrics
• Program & Financial Accountability
  • Manages departmental performance, including productivity, quality outcomes, and resource utilization
  • Participates in budget development, monitoring, and fiscal accountability for the department
  • Aligns departmental operations with organizational financial and strategic goals
• Collaboration & Leadership Influence
  • Partners with physicians, nursing leadership, and interdisciplinary teams to support care coordination and patient outcomes
  • Serves as a key liaison between Care Management and hospital or system leadership
  • Leads and participates in committees, initiatives, and organizational projects
• Decision-Making & Scope
  • Exercises independent judgment in operational, clinical, and personnel decisions
  • Decisions have impact at the departmental and organizational level
  • Responsible for achieving performance outcomes and implementing strategic initiatives
• Additional Duties
  • Performs other related duties as assigned to support departmental and organizational priorities
• Competencies and Skills
• Leadership Competencies
  • Strategic Thinking: Aligns departmental operations with organizational priorities and future goals
  • Integrity and Accountability: Demonstrates ethical leadership and ownership of outcomes
  • Emotional Intelligence: Builds strong relationships and effectively manages team dynamics
  • Develops Self and Others: Coaches and develops high-performing teams
  • Effective Communication: Communicates clearly with all levels of the organization
  • Patient-Centered Care: Drives high-quality, patient-focused outcomes
• Technical Skills
  • Advanced proficiency in spreadsheet, presentation, and word processing applications
  • Ability to analyze data, develop reports, and present operational metrics
    

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:

• RN or Social Worker with current, active, unrestricted RN license in Maine OR active, unrestricted Social Work License in Maine
• 5+ years of relevant clinical or care management experience
• Live in a daily commute distance of Presque Isle ME (this is not a remote-eligible role)
• Willing/able to work full time (Monday - Friday) at a hospital location in Presque Isle ME (this is not a remote-eligible role)

Preferred Qualifications:

• Leadership or supervisory experience

Working Conditions:

• Ability to sit and work at a computer and telephone for extended periods (2-4+ hours)

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.