Director, Health Services - Hybrid - 2147248

Company: UnitedHealth Group
Location: Little Rock
Posted on: March 17, 2023

Job Description:

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) Do you want to make a difference in healthcare? Landmark Health was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to chronically ill patients, many of whom are ill-equipped to navigate our overwhelming healthcare system. Because many of our patients are frail and elderly, we deliver care primarily in the comfort of their home. Our Program is also offered to eligible patients at no incremental financial cost to them. We are not a fee-for-service practice; we benefit economically only if we deliver high-quality patient outcomes and satisfaction. As a result, our clinical teams can spend quality-time caring for a smaller number of patients, giving all patients the space, respect, compassion and care they deserve. At Landmark, our interdisciplinary teams collaboratively manage our complex patient panels. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers, Pharmacists, Behavioral Health, and other employed team members. Join Landmark to be part of a growing company full of purpose-driven, action-oriented, and compassionate team members working to dramatically transform healthcare for our communities. If you are located in the Arkansas, Kansas City or Iowa metro areas, you will have the flexibility to work remotely*, as well as work in the office 1-2 times a week as you take on some tough challenges. OBJECTIVE This role serves as the market level operational lead for the clinical team. Reports to the local VP General Manager and works closely with the local Regional Medical Director. Develops and implements strategy, policy and process to provide quality care and service to our patients. The position oversees and ensures the effectiveness of the day to day operations of the clinical team regarding health plan coordination and communication, scheduling, quality metrics, engagement, geographic alignment of teams, interdisciplinary teams, quality programs, coordination of care, transitions of care, data collection/reporting and quality of care (list is not all inclusive). The position is responsible for relationships with vendors, facilities, health plan case management and health services, community-based providers and community organizations. Primary Responsibilities:

• Oversee and execute innovative models, processes, and programs/pilots in their market
• Execute on changes to structure & policies
• Execute on HP contract expectations and make sure market is meeting expectations
• Implement national pilots in the market
• Manages Clin Sups & SW Sups, has regular 1:1s & manages QPUs
• 1:1s with their Regional HSD
• Manages QIP and QIP exceptions as well as ADP/PTO/concur request
• Executes on standardized processes in mkt
• Accountable for market outcomes (PDV, Quality, UEOC, performance metrics, etc.)
• Reviews market reporting and takes appropriate action (deploys IDT staff effectively, trains, educates, audits, etc.)
• Implements markets on clinical
• Responsible for recruiting, training, performance management and retention of the interdisciplinary team members
• Maintains quality of services through audits and education
• Oversees the management of the day to day operations of the clinical team in the market
• Responsible for external health care facility & vendor relationships (home health agencies, etc.
• Oversees hospice reporting and performance and collaborating with RMds on this
• Execute process changes
• Provides oversight, guidance on using data to manage market
• Oversees processes for inventory of medical supplies, PPE, Supply Closet
• Executing adherence to health service policies
• Aggregating and managing market complaints and grievances
• Managing the medical record request process (disability, PCP, HP etc.)
• Attend and actively participate in targeted contracted health plan IDT, Clinical Operations, JOC's and other operational meetings as needed
• Relationship management with second/third tier IPAs, Targeted HPs and Community PCP in market
• Joins the Quality Management program for the market and raise up updated to regional HSD
• Executes and managing on Quality Measure processes (i.e. ensures that documentation is completed by providers and IDT members timely and accurately and quality gaps are managed)
• On Point for Market QBR prep, material creation, and report-out with Regional and Division Leadership SUPERVISORY
  • Reports directly to the VP General Manager COMPETENCY To perform the job successfully, an individual should demonstrate the following competencies:
    • Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.
    • Technical Skills - Assesses own strengths and weaknesses; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others.
    • Interpersonal Skills - Focuses on solving conflict; maintains confidentiality; listens to others; keeps emotions under control and overcomes resistance when necessary; remains open to new ideas.
    • Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and seeks clarification; responds openly to questions. Must be able to deal with frequent change, delays, or unexpected events.
    • Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.
    • Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate plan.
    • Initiative - Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed; generates suggestions for improving work and workflow. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
      • Current RN License
      • 5+ years of clinical practice in a hospital, clinic, home care, or nursing home setting
      • 5+ years of increasing supervisory or management experience in a health care setting Preferred Qualifications:
        • BSN
        • MBA or Business experience
        • Case management experience
        • Disease and utilization management experience
        • Physician office experience PHYSICAL DEMANDS Below are the physical requirements which are representative of those that must be met by the employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
          • Regular requirement to sit; use hands to touch, handle or feel.
          • Regular requirement to talk and listen.
          • Occasional requirement to stand; walk and reach with hands and arms
          • Occasional requirement to lift and/or move up to 10 pounds.
          • Vision abilities include close vision, peripheral vision, depth perception and ability to adjust focus. WORK ENVIRONMENT Below is a description of the work environment that the employee will encounter while performing the essential functions of the job.
            • Noise level is usually moderate
            • Work is generally in an office setting Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges. *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 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.

Keywords: UnitedHealth Group, Little Rock , Director, Health Services - Hybrid - 2147248, Executive , Little Rock, Arkansas