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Manager, Medical Clinical Operations - Telecommute from NY, NJ or CT

UnitedHealth Group

New York, NY
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Job Details

743750 Manager Medical Clinical Operations Telecommute from New York City or Westchester NY

Manager, Medical Clinical Operations - Telecommute from NY, NJ or CT (743750)

Position Description

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 has responsibility for oversight of all Case Management operations including management of staff, compliance with audits, management of state based initiatives, adherence to NCQA / HEDIS measures and all administrative services to assure the ongoing work of Optum CM New York.

If you are located in New York, New Jersey or Connecticut, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:
  • Manages and is accountable for professional employees and / or supervisors
  • Participates in "ride-along" / audits with the Community Health Workers during field visits with members
  • Sets team direction, resolves problems and provides guidance to members of own team
  • Adapts departmental plans and priorities to address business and operational challenges
  • Influences or provides input to forecasting and planning activities
  • Monitors, manages and controls operational and performance metrics in conjunction with established program value targets
  • Develops solutions to address new, often complex customer requirements that address operational, clinical and customer needs
  • Ensures audits are conducted, standards are met, successful outcome are achieved
  • Reviews operational and performance metrics regularly and drives action plan development and execution
  • Ensures site remains compliance with all applicable regulatory and accreditation requirements (NCQA and URAC)
  • Collaborates across OCHS and UHG including Medical, Site Directors, senior leaders, sales, account management, product organization, and other stakeholders
Required Qualifications:
  • Active, unrestricted RN license in the State of New York OR Master’s degree in Healthcare related field
  • 2+ years of Case Management experience
  • 2+ years of Leadership experience
  • CCM or willingness to obtain within 18 months of employment
  • Proficient in Microsoft Word, Excel and PowerPoint

Preferred Qualifications:

  • BSN 
  • Strong team building, leadership and mentoring skills
  • Demonstrated ability with developing strategic plans, attainable goals, drive performance, and achieve targets
  • Field based or Community based experience
  • 3+ year previous supervisory or management experience (including performance management functions i.e. hiring, performance evaluations, corrective action plans, etc.)
  • Experience working for an insurance company or other managed care setting
  • Experience working with the Medicaid population
  • Certified Case Manager (CCM)
  • Experience with accreditation requirements (NCQA and URAC)
  • Prefer residency in NY, NJ, or CT
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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)

*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: Nurse, RN, Healthcare, Manager, Supervisor, Leader, Case Manager, CCM, MCO, Managed Care, Medicaid, NCQA, URAC, New York City, Westchester, NY, New York, Telecommute, Work From Home, Virtual, New Jersey, Connecticut, CT, NJ, NY

Job Details

  • Contest Number743750
  • Job TitleManager, Medical Clinical Operations - Telecommute from NY, NJ or CT
  • Job FamilyMedical and Clinical Operations
  • Business SegmentOptum Operations

Job Location Information

  • New York, NY
    United States
    North America
  • Other LocationsWESTCHESTER, NY

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelManager
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • 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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