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in Miramar, FL

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Hours Full-time, Part-time
Location Miramar, FL
Miramar, Florida

About this job

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)



The Health Services Director will provide health plan leadership to Optum, United Clinical Services and other segments who supply the clinical support to the C&S Health Plans to include the MMA, DSNP, and FHK programs.


 


Primary Responsibilities:



  • Ensure Clinical Program compliance and Contract requirements are met

  • Development and revision of Clinical Policies and Procedures

  • Oversight of C&S Clinical Administrative Coordinators

  • Oversees timely submission of state complaints

Requirements

Required Qualifications:



  • Current and unrestricted registered nurse license in the state of Florida

  • Master's degree

  • Knowledge of Florida Statewide Medicaid Managed Care program, CMS Medicaid/Medicare and Long Term Care

  • Three years of management experience

  • Ability to travel 25% of the time in Florida

 


Preferred Qualifications:




  • Five years of management experience

  • Experience with Utilization Management, Disease Management

  • Proficient with MS Office Suite

 
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: 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: RN, Director, Nurse, Florida, Miramar, Medicaid, Managed Care, Long Term Care, LTC, Disease Management, Utilization Management, FL