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Director Clinical Call Center Operations- MD or TN

UnitedHealth Group

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Job Details

742110 Director Clinical Call Center Operations MD or TN

Director Clinical Call Center Operations- MD or TN (742110)

Position Description

Medical Director careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Join us. And start doing your life's best work.(sm)


The OptumCare Services Clinical Operations team supports Advanced Practice Clinicians in the HouseCalls and Complex Care Management businesses by providing telephonic consultation to plan members and their healthcare providers in a call center environment.  The Care Services team of call center clinicians includes pharmacists, social workers, dietitians, nurse care directors, and licensed practical nurses.


The Director, Clinical Call Center Operations will report directly to the Sr. Director of Clinical Operations. The Director will supervise a team of Clinical Managers/Supervisors as they manage the day to day operations of interdisciplinary teams of nurse care managers, social workers, dieticians and licensed practical nurses as they perform telephonic clinical consults with members. The Director will be responsible for engaging and coaching their teams to meet or exceed established productivity and quality metrics.  The Director will work with the directors of clinical operations that lead the pharmacy team to align processes, policies, and procedures to ensure consistency across the department.  Additionally, the Director will contribute to projects led by the Program Management, Program Performance, and Business Operations teams.  The Director will perform telephonic clinical consults on an “as needed” basis.


Primary Responsibilities:

  • Lead and develop staff (4 - 6 Clinical Manager / Supervisor with approx. 80 rolling up structure)

  • Serve as a mentor, a coach and a promoter of professional development

  • Manage a team of Clinical Team Managers / Supervisors

    • Ensure that their teams are achieving or exceeding production and quality metrics
    • Analyze performance statistics of teams to identify opportunities for coaching
    • Assist with the implementation and monitoring of corrective action planning
  • Ensure that staffing levels of the Clinical Call Center are maintained at all times

    • Oversee recruitment activities

    • Drive employee engagement and perform random audits to ensure that employees maintain job satisfaction

  • Work with Sr. Director and Senior Leadership to adapt team plans and priorities to address business and operational challenges

  • Communicate organizational priorities and vision to team members

  • Create and / or revise departmental policies, job descriptions, and standard operating procedures to ensure compliance with CMS, STARs, and HEDIS requirements

    • Work with Sr. Director and other Directors of Clinical Operations to align processes, policies, and procedures across the department

  • Serve as a conduit between the call center clinicians, Clinical Managers / Supervisors, Sr. Director and Director of Business Operations to achieve high operational efficiencies

    • Identify and organize metrics that are usable and actionable on the supervisor level

    • Ensure that staffing resources are allocated correctly, and shifted appropriately when necessary

    • Resolve any discrepancies within production reports

    • Identify, report, and troubleshoot any operational issues that prevent call center clinicians from performing their day to day activities

  • Maintain the clinical integrity of programs offered

  • Serve as a clinical resource and consultant in all clinical areas

  • Enhance Employee Development at both the Clinical Manager / Supervisor level and the call center clinician level

  • Assist with, and participate in, training programs related to Productivity, Quality, Health Literacy, and Medicare STARs / HEDIS initiatives

  • Support medical management and clinical / quality initiatives across the organization

  • Support the Business Operations Team with platform enhancements / testing  / functionality, when needed

  • Assist the Program Management team with implementing new initiatives, when needed

  • Perform clinical consults with members on an ‘as needed’ basis, as determined by business needs

Required Qualifications:

  • RN or NP with active, unrestricted license
  • 5+ years RN/NP clinical experience
  • 3+ years leadership experience inclusive of operations management
  • Experience successfully driving to metrics
  • Working knowledge of HEDIS, Stars, quality initiatives
  • Experience developing and implementing policies, procedures
  • 1+ year working across multiple disciplines, departments and levels of leadership
  • Proven track record of strong performance management and developing teams
  • Ability to manage multiple complex, concurrent projects
  • Excellent written and verbal communication and relationship building skills

  • Proficient with Microsoft Word, Excel, Outlook, PowerPoint

  • Ability to travel up to 20% (primarily Franklin, TN & Baltimore, MD)

Preferred Qualifications:

  • Experience with Disease State Management, Chronic/complex conditions
  • URAC approved Case Management certification within two years of assuming the position

  • Case Management experience

  • Experience in managed care, call center, or telephonic care environments is a plus

  • Experience managing a large staff to leader ratio 

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 6, 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: 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 Details

  • Contest Number742110
  • Job TitleDirector Clinical Call Center Operations- MD or TN
  • Job FamilyMedical and Clinical Operations
  • Business SegmentOptumCare

Job Location Information

  • MD
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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