Medical and Clinical Operations RN Manager - Office Based - Elkridge, MD

In close collaboration with the Site Director, the Medical and Clinical Operations RN Manager ensures that multiple clinical programs and business expectations across multiple customer teams are managed based on standard operating procedures and practices.  The Medical and Clinical Operations RN Manager nurses that Managers, Supervisors and staff members work collaboratively as a team, are focused on clinical quality, efficiency and effectiveness to achieve established targets and goals, providing a positive, and most importantly a seamless experience to the consumers we serve.
 
Primary Responsibilities:


Oversees clinical service delivery and reviews clinical judgment of staff, together with Site Director and Medical Director

Ensures consistent service delivery is maintained by managing staffing levels, monitoring metrics, process improvement, and general human resource management to achieve both clinical quality and costs effective outcomes

Actively participates in site leadership team accountable for managing multiple teams and Clinical Managers/Supervisors providing Case and Disease Management services

Responsible for professional development, coaching and mentoring of Clinical Managers / Supervisors under direct supervision.

Works closely with site leadership team to establish site business plan, strategic initiatives and action plans within the site

Works closely with Site Director to provide team direction, resolve issues, and provide guidance and coaching to Clinical Managers / Supervisors and staff

Develops solutions to address new, often complex customer requirements that address operational, clinical and customer needs

Primary clinical point of contact for services under direct supervision for both internal and external stakeholders including customers and vendor partners

Assist in the review and analysis of clinical and operational reporting information, acting as the subject matter expert for account management

Communicates effectively with all levels of customers and consultants from Executive to HR / Clinical Analyst. 

Able to build rapport with customers, to understand their needs, and articulate the capabilities/limitations of the clinical operations team to support those needs

Ensures standard operating procedures are followed, and internal programs are managed as agreed upon contractually

Ensures site remains in compliance with all applicable regulatory and accreditation requirements (NCQA and URAC)

Sets team direction, resolves problems and provides guidance to members of own team

Adapts departmental plans and priorities to address business and operational challenges

Influences or provides input to forecasting and planning activities

Decisions impact multiple groups of employees and customers (internal and external)   

Required Qualifications:


Current unrestricted RN license in State of Maryland

5+ years RN level professional experience

3+ years leadership, supervisory, or management experience

BSN or Bachelor’s Degree in Healthcare Management

Strong business, organization and communication skills

Strong computer and systems experience with proficiency using MS Office products and web browser applications
Preferred Qualifications: 


Mandatory certifications: URAC approved Case Management certification within two years of assuming the position

Experience in managed care, call center, or telephonic care environments is a plus

Experience managing a large staff to manager ratio
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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: Medical and Clinical Operations RN Manager, Elkridge, MD, Maryland
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