***10K Sign on bonus for external candidates***
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
Primary Responsibilities:
- Focusing on the areas of utilization management, quality improvement, cost containment and personnel management
- Provide innovation and input to improve member care, operational efficiency, and regulatory compliance
- Interact with our corporate officers, including the CEO, Medical Director, Director Medical Management and Associate Vice President, Medical Management
- Develop, motivate, and challenge staff to optimize their capabilities
- Facilitate training and cross-training of staff, in conjunction with corporate department, to maximize effectiveness and utilize staff to their fullest potential
- Maintain ongoing communication and feedback with customers and/or clients in order to support needs and resolve problems
- Maintain department expenditures within budget and work with the ED and group Medical Director to develop the annual department budget
- Ensure periodic program evaluation to assure improvement and health plan and regulatory agency compliance
- Oversee the Utilization Management Committee and ensure adequate representation for UM on all work teams and committees
- Work with the ED, Medical Director, Director of Med Mgmt and AVP to prepare staffing and growth requests using valid statistical assumptions to support requests
- Assist other IPA departments with staffing and growth difficulties by sharing staffing resources
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:
- Current RN or LVN license in California
- 2+ years of Management and supervisory experience in Utilization Management
- 2+ years of experience in acute care (ICU, CCU, ER, med-surg) or related health care experience
- 2+ years in a managed care environment and/or health plan
- Knowledge of general PMG/IPA operations
- Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance
Preferred Qualification:
- Associates/Bachelor’s degree
- Ability to manipulate databases to produce meaningful analytic reports
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)
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.