Unitedhealth Group Inc. Richmond , VA 23234
The Clinical Program Manager will support the MLTSS program in the state of VA. This individual will work closely with our Community Based Partnerships and the care coordination team to implement and comply with our care model and visit requirements. The Clinical Program Consultant is responsible for the development and/or on-going management and administration of clinical programs
This role will be based out of the Richmond office with possibility for telecommute after 6 months of employment. Also requires potential regional/state travel when needed.
Training and mentoring staff on our clinical platform to ensure metrics are met and tracked accurately
Provide excellent customer service to our community partners, work closely with provider relations to promote and deliver our care model, as well as comply with our governmental contract requirements
Compliance responsibility, coordinate meetings at agencies, handle clinical issues and work with clinical region
Travel to offices of our contracted providers and to meetings with the state of Virginia
Develop policies and procedures to ensure adherence to the care model
Communicate and collaborate with key stakeholders regarding findings and recommendation
Perform, assist with or oversee audits (e.g. clinical financial, external, regulatory, process, compliance, quality)
Monitor compliance against relevant process requirement
Evaluate processes and outcome against benchmarks and metrics and identify potential business impacts of current state.
Identify opportunities to increase efficiencies of effectiveness and recommended program implementation or process changes
Bachelor's Degree in Social Work, Public Health, Health Administration and / or an RN with a current and unrestricted license in the state of VA
Experience in home health care, case management, provider relations, community health and / or managed care
Experience with underserved and / or Medicaid population
Proficient in MS Office programs and Internet
Ability to travel locally, regionally and throughout the state of VA when needed
Supervisory / leadership experience
Clinical quality experience
Experience in the creation and delivery of presentations
Government contract experience
Experience with Visio
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.
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