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WyHealth Regional Manager Clinical - Medical Operations - Southeast Wyoming

UnitedHealth Group

Cheyenne, WY
Job Code:
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WyHealth Regional Manager Clinical - Medical Operations - Southeast Wyoming(Job Number:730151)

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 works with WyHealth regional Medicaid and is responsible for satisfaction, utilization metrics, quality metrics (for both Medicaid client and provider) and provider satisfaction in your region.  The Regional Manager achieves success in these areas by leveraging the skill sets of its multi-discipline direct reports, both dotted line and direct.  This position will require travel within your region approximately 35% of the time and will be telecommuting/working from home when not in the field.  Candidates must reside in the state of Wyoming.  Territory listed below.


Primary Responsibilities:

  • Assimilate the contributions of both care management and provider services team members to achieve the State of Wyoming’s WyHealth contract deliverables for its Targeted and Complex Case Management programs
  • Facilitate a multi-discipline, regional team made up of clinical and non-clinical care management staff and provider service personnel.  Activities will include, but not be limited to regular team meetings, review of panel management results, regional data analytics review and interpretation, etc.
  • Develop local/regional strategies to achieve both clinical and business objectives, incorporating effective execution of State of Wyoming contract requirements
  • Use regional data (e.g. operations, utilization, provider and patient quality, etc.) to inform the development of above regional strategy.
  • Translate State of Wyoming Contract requirements to field staff in the form of day-to-day operations guidance
  • Provide direct management and oversight of exempt and non-exempt care management staff
  • Coach both care management and provider services team members in applying a quality improvement/practice transformation lens to development of improved internal/external workflows as well as approaches in working with providers/facilities
  • Provide oversight of and accountability for care management team member proficiency in standardized workflows and documentation
  • Provide operational audit review and remediation oversight at the regional level
  • Development of key stakeholder relationships, particularly at the regional level, with involvement of individual team members as indicated
  • Prioritize care management team member professional development

Territory for this position is the following counties:  Carbon, Albany, Niobrara, Goshen, Platte, Laramie

Job Med & Clin Ops-General Mgmt
Primary Location US-WY-Cheyenne
Other Location US-WY-Laramie-Wyoming, US-WY-Torrington-Wyoming, US-WY-Rawlins-Wyoming, US-WY-Wheatland-Wyoming
Organization Optum Ops - PHM UMR
Schedule Full-time
Number of Openings 1
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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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