Director Clinical Operations, (RN/NP) CPM - Nevada market
Location: Las Vegas Nevada
Description: UnitedHealth Group is currently interviewing Director Clinical Operations, (RN/NP) CPM - Nevada market right now, this job will be placed in Nevada. For complete informations about this job opportunity please read the description below. The Director of Clinical Operations is responsible for clinical operations and medical management activities across the continu! um of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. The Director of Clinical Operations may also be responsible for providing health education, coaching and treatment decision support for members. In the Nevada market, the Director of Clinical Operations will also have client management responsibilities. Major Responsibilities include: General~
Strategize, develop and direct operations of the health services department to ensure provision of high quality, cost-effective medical service
Responsible for the development and management to budget related to medical care, direct actions to achieve program metrics and value proposition for the clinical programs in Nevada
Development of site budget in conjunction with Regional President
Client management~
Conduct monthly joint operating committee meetings with client; reviewing o! perational and clinical metrics and client value report
En! sure compliance with State and Federal regulations, compliance with company policies and procedures.
Form internal and external strategic relationships which will support program expansion and continuing success
Provide leadership to and be accountable for the performance of managers and/or senior level professional staff.
Medical Management~
Develop and routinely update comprehensive medical management work plans/programs for all programs.
Review periodic reports (financial/utilization/services) analyze trends and implement timely corrective action plans
Review and implement medical management policies and procedures to ensure compliance with the State and Federal regulations
Strategize and implement a clinical model which is focused on quality, reduces medical cost appropriately and which incorporates the skills of provider partners whenever possible
Program Quality~
Direct the development of well designed processes which when! fully implemented, will be evident in daily work flows which are efficient and support the achievement of the site goals.
Conduct regular meetings with staff to address issues, concerns, and to communicate corporate and site-specific philosophy.
Oversee the integrity of the patient-data base system to ensure consistency in the data entry and the integrity.
Coordinate plans with the local and national quality committee to comply with regulations and accreditation agencies
Business Development~
Strategize and identify opportunities for expansion of Optum Complex Population Management to other payers in the state of Nevada
Strategize with the senior staff about program expansion/development/new models/new alliances.
Implement new programs or new care models
Staff Retention and Development~
Manage 19 direct reports (Licensed Behavioral Health clinicians in call center fielding calls from employees, family members, clinicians, etc.)! salary, bonus incentives and enforce work rules in a manner that rewar! ds excellent performance and minimizes staff attrition while meeting budget requirements.
Direct the orientation, training, and on-going education and skill development of the institutional health services staff.
Conduct meetings with staff to address issues, concerns, and communicate site and corporate philosophies and directives.
RN or Nurse Practitioner with current, unrestricted NV licensure
Master's Degree in nursing, health sciences, social services or business preferred
3 or more years hands on clinical experience
3 or more years experience directly managing staff required
Outstanding leadership skills including strategic planning experience
Strong relationship and negotiation skills, budget management experience and regulatory knowledge.
Leadership and management experience in effective team building and continuous quality improvement programs.
Working knowledge and experience in cross-functional business segments and their in! tegrated influences and relationships.
Effective and experienced in motivating and mentoring others who are not in a direct reporting relationship.
Ability to travel locally up to 25% of the time to business meetings
UnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 25, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your! dreams.Diversity creates a healthier atmosphere: equal opportunity emp! loyer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
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This job starts available on: Sat, 09 Nov 2013 22:37:46 GMT
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