Manager of Case Managers - Multiple Locations - TN

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United HealthGroup Community, CHOICES program offers person-centered care planning, service coordination and support services for members receiving long-term care (LTC) and home and community (HCBS) services. The Manager of Care Management (MCM) is responsible for providing oversight of long-term care (LTC) and home and community based (HCBS) services.  The care coordination team facilitates, promotes and advocates for the member’s ongoing self-sufficiency and independence.
 
Additionally, the care coordination team is responsible for sustaining the natural supports of the member.  This includes but is not limited to assessing the availability of natural supports, representative or family members to ensure the ongoing mental and physical health of those natural supports.
 
This position supports Maury, Giles, Lewis, Hickman, Marshall, Williamson and Lawrence counties in Tennessee.
 
Primary Responsibilities:


Supervise, direct and evaluate a diverse group of health care professionals to assure effectiveness of care coordinators activities, which include, but are not limited to, routinely assessing and monitoring members’ status, needs and progress; developing individual plans of care for members; managing critical transitions, coordinating appropriate treatments and services, identifying and communicating opportunities for care intervention; authorizing care services; monitoring and ensuring the provision of covered services as a cost-effective alternative; developing and implementing targeted strategies to improve health, functional and quality of life outcomes; proactively educating members; conducting, reviewing and revising member’s risk assessments and risk agreement; maintaining appropriate and ongoing communications and collaborations with members, their authorized representative and providers; and reporting quantifiable impact, quality of care and quality of life improvements as measured against care coordination goals
Interviewing, hiring, disciplining, evaluating and mentoring a diverse care coordination work force
Onboard new staff including but not limited all pre-employment human resource tasks, ordering of software, hardware, supplies and support technologies
Active participation in the preceptorship of new CHOICES clinical staff, providing the level and degree of support needed to ensure that newly assigned CC’s are competent in the Care Coordination process
Develop and initiate new employee orientation core curriculums and obtain complete sign-off of orientation tasks list prior to assignment of permanent caseload
Conduct all relevant activities related to exiting clinical staff to ensure that all Company assets (computers, printers, cell phones, Air Cards, and other related equipment) are retrieved in accordance with company policies
Under the supervision of the Health Services Director (HSD), provide and / or coordinate staff training for maximum performance and provide developmental opportunities
Promote teamwork and a positive working environment for the care coordinators
Responsible for communication and mentoring members of the care coordination team to ensure long-term and home and community base d care guidelines, policies and procedures are followed
Monitor performance of staff including service performance and adherence to establish utilization and care coordination benchmarks
In collaboration with the HSD will create and monitor development plans for direct reports who need additional coaching in performance area
Will develop and  implement, in collaboration with the HDS Corrective Action Plans for those direct reports who are not meeting performance expectations
MCM’s will support those direct reports with performance issues through coaching in the development and implementation of formal Develop Plans for each direct report and Corrective Action Plans when performance warrants
Actively participate in the MAP process, developing annual MAP goal, in collaboration with HSD’s for direct reports and monitoring progress on a regular basis
May be required periodically to staff a  case load of members, when dictated by census fluctuation or staffing coverage
Performs comprehensive member assessment, develops plan of care, risk assessment and all necessary enrollment documents within contractual compliance and provides primary technical support/assistance to subordinates for these job functions
Ensures contract compliance for new member outreach, initiation of services, visit compliance, initial, monthly, quarterly and / or annually
Develop and implement coaching plans for employees falling below 90% visit compliance and / or 100% initiation of services to ensure that employee comes within compliance within one month
Will report to HSD during weekly 1:1 on employees out of compliance and / or strategies and plans to ensure employees compliance
Responsible to ensure 100% initiation of service compliance
Responsible to lead collaborative CMA ORR calls related to initiation of services
Develops and maintains an intermediate to advanced functioning in CareOne, Word, Excel, Outlook, Visio and other applicable software platforms
Serves as team’s primary support for technologies, including but not limited to PC / laptop, air care, cell phone, etc.
Performs ride along visits with each assigned staff member to observe assigned employee’s performance, as appropriate to manager the employee
Other duties deemed necessary for effective and efficient team operations

Required Qualifications:

Registered Nurse with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse License Compact Law; or master level Social Worker with active license in the state of Tennessee (LCSW, LMSW or LAPSW)
Minimum 2 years of health care experience in managed and / or long-term care
3 - 5 years supervisory / management experience
Intermediate to advanced expertise in Word, Excel, and Outlook
Preferred Qualifications:

Prefer 3 years experience providing care coordination to persons receiving long-term care and / or home and community based services
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: Manager Case Managers, Springhill, Columbia, Lewisburg, Lynnville, Lawrenceburg, TN, Tennessee