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Manager of Care Advocacy - Tacoma, WA

UnitedHealth Group

Tacoma, WA
Job Code:
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Job Details

Manager of Care Advocacy - Tacoma, WA(Job Number:711652)

Talk about meaningful work. Talk about an important role. Let's talk about your next career move. 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)

Overall responsibility for the Manager of Clinical Operations is Utilization Management and Care Management, including day-to-day oversight and supervision of Care Managers and Discharge Coordinators. This position will include clinical training, staff orientation, risk management, and working with the Associate VP of Clinical Operations to ensure implementation of the Utilization Management Plan. This position will serve as the primary point of contact for Medical Health Plans and primary care providers and will also provide clinical backup and perform the Care Manager duties as needed.
***This is an office position located at 3315 S 23rd Street Tacoma, Washington***
Primary Responsibilities:
  • Responsible for the implementation of Clinical Practice Guidelines and auditing records to determine compliance with them
  • Monitors the performance of care management staff to ensure standards and targets are being met using call observation and silent call monitoring, inter-rater reliability testing, analysis of aggregate data, chart and online audits, and review of the quality and accuracy of information provided to callers
  • Facilitates daily clinical unit meetings and attends case review meetings with the Medical Director
  • Works with QA/PI Manager to assure that quality standards and processes are integrated into the Care Management Unit
  • Has a leadership role in the Utilization Management Committee and integrates overall utilization management activities into the Care Management function
  • Works closely with Information Technology Unit to determine and capture data related to clinical outcomes
  • Provides overall project management for the development and revision of policies and procedures. Writes all Care Management policies and procedures and provides subject matter consultation for all policies and procedures that indirectly impact the Care Management functions
  • Maintains knowledge of current legislation and State and Federal administrative codes and assures that Care Management functions comply with all regulations.
  • Prepares and/or monitors preparation of documentation required for clinical reviews and on-site audits
  • Works collaboratively with the Medical Health Plans that serve Pierce Medicaid Healthy Options beneficiaries including providing clinical consultation, establishing referral protocols, consistent application of Access to Care criteria

Job Care Advocacy
Primary Location US-WA-Tacoma
Other Location 
Organization Behavioral Sol - Public Sector
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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