LTC Process Manager - FL Telecommute Opportunity - Full-time / Part-time

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm)

This position is required to ensure compliance with the requirements of our contract with the Agency for Health Care Administration. This position will ensure that policies and procedures are maintained related to LTC members maintaining Medicaid eligibility and level of care designations in compliance with the contract and its amendments.

The LTC Process Manager acts as a SME with the contract, keeps abreast of changes and ensures changes are incorporated in clinical processes as they relate to PASRR, Freedom of Choice, and multiple Agency for Health Care Administration related reports such as monitoring Initial Assessment completion, members declining services, and members that are unable to reach. The Manager will work closely with Clinical Analysts in developing and maintaining accurate reports, data and ability to report out to teams. The Manager will also work with the Quality department to implement and monitor the various Process Improvement Projects that are a part of the contract and help to improve outcomes.

Primary Responsibilities:

• Acts as a subject matter expert in our contract with the Agency for Health Care Administration 


• Keeps abreast of any changes in federal, state and regulatory agency policy and ensures that those changes are reflected in the applicable policies and procedures 


• Works with Director of Clinical Ops & Process and other managers to ensure that changes in external and internal policies affecting the program are communicated and implemented in a timely fashion 


• Work closely with the Manager of Clinical Training to ensure that all staff is educated on any changes to policies 


• Manages and is accountable for professional employees and/or supervisors 


• Work closely with Quality on Process Improvement Projects (PIPS)
  

Required Qualifications:

• At least a Bachelor's Degree level of education (Health Care or related field preferred) 


• Permanent residence in the state of Florida 


• 2+ years of experience working in the Long Term Care program; specifically with level of care designations 


• Knowledge of Managed Care and Medicaid (State of Florida) 


• Familiarity with Governmental program requirements 


• Experience collecting, extracting and interpreting complex data 


• Excellent verbal and written communication skills 


• Proficiency in Microsoft Office Suite

Additional Preferred Assets:

• Master's Degree 


• Supervisory/Management background 


• Project Management/six sigma experience 


• Quality Management experience
  

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.

Keywords: LTC, long term care, Medicaid, AHCA, Agency for Healthcare Administration, quality, process improvement, FL, Florida, telecommute, work from home