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UnitedHealth Group Associate Health and Social Services Director - Telecommute in MA in Waltham, Massachusetts

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

UnitedHealthcare Community & State Senior Care Options plan is a Fully-Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually-eligible individuals in the Commonwealth of Massachusetts aged 65 or greater. This position sets team direction, resolves problems and provides direction to Manager of Case Managers. This position adapts departmental plans and priorities to address business and operational challenges such as Staffing, the clinical model and inter-departmental actions and goals.

If you are located in the state of MA, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Leadership

  • Manages a diverse team of leaders, with varying levels of management expertise and skill sets

  • Hires, manages and develops managers. Proactively monitors individual and team performance and provides frequent and ongoing feedback and coaching

  • Supervises a team that varies in size based upon capacity plans and staffing models. Direct reports are located at same site, work at home or a remote UHC site

  • Participates in initiatives that improve the constituent experience. Contributes subject matter expertise and/or carries out project assignments in a timely and effective manner

  • Serves for division-wide operational performance improvements or initiatives that involve quality and service delivery

  • Participates in organizing and executing site visits for prospective / existing clients and/or UHC and UHG leadership

  • Displays leadership and business acumen while hosting site visits by UHC and UHG executives and/or current or prospective customers

  • Utilizes Our United Culture concepts and tools and delivers on the commitments. Holds supervisors accountable to application and use of Our United Culture concepts and tools

  • Demonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high performance environment

  • Recommends and approves promotion, assignment and compensation decisions based on performance track record, potential and business needs

  • Drive Effective Clinical Decisions within a Business Environment: Operational Performance

  • Develops and/or implements bottoms-up strategies to improve operational performance

  • Continually stays abreast of operational performance, identifies degradation in service levels and leads remediation of issues

  • Interview and selection decisions on new hire staffing as well as coach / supervisor roles within their own hierarchy

  • Holds managers and key partners accountable for a successful new hire onboarding experience

  • Responsible for creating a positive and meaningful onboarding experience for all employees, as well as coach / supervisors

  • Delivers and documents one-on-one coaching to improve all aspects of performance and effectiveness

  • Completes “side-by-side” monitoring / coaching with direct reports on a regular basis

  • As needed, prepares, delivers and manages remediation plans

  • Participates in job fairs, open houses and other recruitment events as needed

  • Ensure compliance with Model of Care and State contractual requirements (Chart audits)

  • Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results

  • Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results

  • Use appropriate business metrics (e.g. member / FTE, length of stay, readmission rates, STAR ratings, member engagement rates) and applicable processes / tools (e.g. cost benefit analysis, return on investment, performance, staffing calculator) to optimize decisions and clinical outcomes

  • Prioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build consensus to triage and deliver work (e.g. assessments, case / claim loads, previous hospitalizations, acuity, morbidity rates, quality of care follow up.)

  • Understand and operate effectively / efficiently within legal / regulatory requirements (e.g., HIPAA, CMS, State.)

  • Coaching & Performance Management

  • Monitors and holds managers accountable for communicating and performance feedback with direct reports on a regular basis

  • Monitors and holds supervisors accountable for following through on timely performance management in accordance to UHG policies and practices

  • Ensures the effectiveness of the performance management process, including MAPs and CAPs

  • Proactively monitors and takes corrective action as needed to ensure operational performance metrics meet and/or exceed contractual terms and/or the criteria to achieve performance guarantees. As needed, participates in client meetings and reviews operational performance metrics

  • Works with supervisors and HRdirect on all termination recommendations and partners with director on termination decisions

  • Ensures coaches / supervisors are validating actual overtime worked against overtime entered into the time and attendance system. Tracks and manages attendance and punctuality in a timely and accurate manner

  • Communicates with direct reports on a regular basis through coaching sessions and by providing timely, actionable feedback

  • Ensures performance metrics and goals are reviewed on a regular and frequent basis with RN case managers and Supervisors, with time set aside for incidental issues

  • Provides purposeful and actionable development feedback to direct reports and monitors to support their performance improvement

  • If, after the action items of the development plan do not yield the desired positive results in the agreed upon timeframe, a CAP is initiated in accordance to UHG policies and practices

  • Works with HRdirect on disciplinary actions or terminations and seeks manager approval on all terminations

  • Tracks and manages attendance and punctuality in a timely and accurate manner

  • Development & Employee Engagement

  • Monitors and holds coaches / supervisors accountable for regular, meaningful and candid development discussions with direct reports

  • Holds coaches / supervisors accountable for preparing and delivering thorough, actionable and meaningful performance feedback and purposeful, actionable development plans

  • Encourages a culture of career exploration and development. Guides employees to leverage available training and development resources

  • Mentors and develops coaches / supervisors to build leadership skills

  • Demonstrates importance of employee engagement by focusing on priority areas with meaningful action plans throughout the year

  • Creates purposeful and actionable development plans with RN case managers as well as reviews with employees and monitors to support their performance improvement expectations and development

  • Engages in regular, meaningful and candid development and career discussions with RN Case managers. Analyzes and understands Vital Signs survey results and communicates results to team members. Works to establish action plan to address opportunity areas and improve results

  • Supports overall organization in employee engagement programs and communications

  • Communication

  • Provides regular manager-to-team communication and provides a forum where information about the department is shared and cascaded in a timely manner

  • Regularly leverages various communication channels, including one-on-one and skip level meetings, new hire class leadership interactions and focus groups to foster two-way communication. Inspires employees to see the link between their position and personal performance to organizational strategy, company performance and the UHC brand

  • Demonstrate Business and Industry Knowledge:

  • Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases)

  • Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid,) or regulatory bodies (e.g., EOHHS, HIPAA, Milliman,)

  • Demonstrate understanding of relevant health care benefit plans

  • Demonstrate knowledge of applicable area of clinical specialization

  • Utilize resources to enhance professional practice and development based on learning gaps or new information

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:

  • Unrestricted RN license required with a BSN, other Bachelors’ Degree, or higher

  • 3+ years of care management experience

  • 3+ years clinical leadership experience

  • MS Office proficiency particularly PPT and Excel

  • Resides in Massachusetts

Preferred Qualifications:

  • MSN, MBA, and / or similar experience

  • DSNP / Medicare Advantage clinical leadership role experience

  • Excellent presenting skills with complex data and outcomes to executive teams

  • Curious, adaptable, flexible, and able to work with changing direction and priorities

  • Ability to organize and thrive in a fast-paced matrixed environment

  • Proven interpersonal, communication and relationship building skills

If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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: Associate Health and Social Services Director, Care Management, Clinical Leadership, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Waltham, MA, Massachusetts