Manager Medical Clinical Operations Charleston South Carolina

Unitedhealth Group Inc. Charleston , SC 29402

Posted 5 months ago

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

This position will be responsible for supervising a team of outbound call center agents and/or field based staff. The team is responsible for working with medical practices to coordinate outreach to Medicare Advantage members to ensure the recommended preventive health screenings are completed and gaps in care are addressed. Travel is required both in state and out of state to visit physician practices and field-based staff as needed.

Primary Responsibilities:

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

  • Ensures team meets established performance metrics, performance guarantees, and quality standards

  • Manages administrative and clinical operations consisting of field based and/or contact center based staff

  • Manage relationships with physician practices

  • Manage implementation of new physician practices and deployment of resources

  • Manage client relationships

  • Collaborate with cross functional teams on practice specific strategies to improve Medicare Stars ratings

  • Takes the lead role in setting direction and participating in or developing new programs

  • Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff

  • Work most often impacts a large business unit, or multiple markets/sites, or at the segment/market group level for functional staff positions

  • Drives performance through audits and coaching to team personnel to ensure products and services fully meet the client expectations while maintaining efficient and profitable operational delivery

  • Assure the onboarding and training of new and existing staff to support product growth and service enhancement

  • Fiscal and operational discipline and management

Required Qualifications:

  • Bachelor's degree in applicable area of expertise or equivalent experience

  • 2 years of supervisory experience

  • Medical / Healthcare industry experience

  • Customer service management experience

  • Knowledge of Benefits and Claims Systems and Operations

  • Strong inbound and outbound telephonic skills

  • Proficient in MS Office Suite (Word, Excel, PowerPoint, Outlook)

  • Ability to travel up to 50% of the time

Preferred Qualifications:

  • Knowledge of call center performance measurement systems and metrics (i.e. ASA, AHT, Service Level)

  • Project/Product coordination/management skills

  • A background in managed care

  • Medicare Stars experience

  • HEDIS experience

  • Strong organizational skills and multitasking abilities will be keys to success

  • Project management experience

  • Quality or Six Sigma experience

  • Teambuilding and leadership skills

  • Effective skills in motivating and mentoring others

  • Excellent communication and presentation skills

  • Demonstrated ability to identify with a consumer in order to understand and align with their needs and realities.

  • Demonstrated ability to perform effective active listening skills to empathize with the customer in order to develop a trust and respect.

  • Demonstrated ability to take responsibility and internally driven to accomplish goals and recognize what needs to be done in order to achieve a goal(s).

  • Demonstrated ability to turn situations around and go above and beyond to meet the needs of the customer.

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: Stars, Performance Manager, Quality Advocate, Quality, Project Management, Consulting, Providers, Member Groups, Contracts, Health Plan, Quality Improvement, Field Based, South Carolina, Charleston, Summerville, SC


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Manager Medical Clinical Operations Charleston South Carolina

Unitedhealth Group Inc.