Health Services Director - Johnson City and Nashville, TN - Full-time / Part-time

• Management of daily clinical operations, management and oversight of multiple levels of staff
• Ensures ongoing monitoring and oversight of CHOICES long term services and support to meet defined goals / targets, as well as ensuring compliance with state rules, regulation and contractual requirements
• Leadership, mentoring and development of clinical leadership staff
• Develops and executes care coordination strategies and operational objectives for the CHOICES program to ensure customer (both members and state partner) satisfaction
• Along with medical director(s) and the clinical team, identifies analyses and drives plan healthcare affordability initiatives in LTSS
• Serves as the CHOICES program SME and liaison with our internal health plan leadership, shared services leadership and state partners
• Provides leadership/management and guides strategies for meeting goals in LTSS Special Programs / Projects (i.e. Nursing Facility to HCBS Transitions, HCBS Consumer Directed (CD) services, Community Living Supports (CLS) Services, ERC Services oversight, CEA and Short Term Stay oversight site etc.)
• LTSS CHOICES Policy and Procedure, SOP reviews, updates and maintenance.
• SME in coordination of LTSS benefits with other C&S benefits (DSNP, Optum Care Plus, PCCM, BH, DME etc.)
• LTSS CHOICES population health management and strategies (Hospitalizations, ER diversions, NF diversions, PCP engagements etc.)

• Bachelor’s Degree or Masters in Nursing  
• Licensed Registered Nurse (RN) or Advanced Practice Registered Nurse.(APRN) (NP)(FNP) (GNP)
• 2+ years within a managed care organization or long term care organization
• 3+ years of Leadership / management experience aligned with effective team building
• Experience or ability take leadership in a matrix organization
• Ability to lead or manage projects to completion
• Ability to travel to state meetings or offices as needed
• Resides or ability to relocate to Middle, TN area

• 2+ years providing care coordination within LTSS
• Experience dealing with Medicare, Medicaid, government and CMS regulations
• Master’s Degree in Business or Healthcare Administration

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SM

 

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.

 

 

Job Keywords: nursing, registered nurse, managed care, long term care, Johnson City, Nashville, TN, Tennessee