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Clinical Program Manager - Richmond, VA

Expired Job

Unitedhealth Group Inc. Richmond , VA 23234

Posted 2 months ago

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.

Primary Responsibilities:

  • 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

Required Qualifications:

  • 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

Preferred Qualifications:

  • 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)

  • All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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: RN, Nurse, Social Work, Public Health, Health Administration, Case Manager, VAMLTSS, CCM, Medicaid Waver, Behavioral Health, Public Health, Provider Relations, Community Health, Long Term Care, Rehab, Home Care, Care Coordination, Home Health, Clinical Quality, Complex Case Management, Managed Care, Bilingual, Richmond, VA, Virginia, UHG, UnitedHealth Group, UHC, UnitedHealthcare, Community and State, Public Sector


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Clinical Program Manager - Richmond, VA

Expired Job

Unitedhealth Group Inc.