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Director, Clinical Operations (Upstate, NY)
| Hours | Full-time, Part-time |
|---|---|
| Location | Rochester, NY Rochester, New York |
About this job
We are looking for a Director, Clinical Operations to join our team in Upstate, NY.
The Director of Clinical Operations will have overall accountability for Program Quality, Internal and External Strategic Partnership and Staff Performance, Retention and Development.
Specific Responsibilities include:
Oversee Revenue Accuracy and Medical Management.
Develop and routinely update comprehensive medical management work plans and programs.
Lead the medical expense data analysis to improve outcomes relative to targets and meet budgeted metrics.
Strategize and implement our clinical model focused on quality, reduced medical cost and incorporating the skills of provider partners.
Review medical management policies and procedures to ensure compliance with State and Federal regulations along with Evercare clinical protocols.
Provide oversight and monitoring of clinical documentation and coding initiatives to achieve site revenue accuracy.
Requirements
Requirements:
R.N. degree with active license or NP required
Masters degree preferred; ideally in nursing, health sciences, social services or business an asset
3-5 years leadership and management experience in an organization that serves the elderly population preferred
3+ years' experience with Medicare, Medicaid and managed care in a variety of health care settings a plus
3-5 years operations experience preferred
Keywords: Nurse, Operations, Clinical, Oversight.
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 14, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
Diversity creates a healthier atmosphere: 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.