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UnitedHealth Group Assistant Manager, Utilization Management - Telecommute in La Crosse, Wisconsin

At Optum, the mission is clear: Help people live heathier lives and help make the health system work better for everyone.

LHI is one of 4 businesses under OptumServe. OptumServe provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well - being of Americans. By joining OptumServe you are part of the family of companies that make UnitedHealth Group a leader across most major segments in the U.S. health care system.

LHI was founded in 1999 and acquired by Optum in 2011, LHI specializes in creating and managing health care programs through on - location services, patient - specific in - clinic appointments, telehealth assessments, or any combination based on customer need.

LHI's customizable solutions serve the diverse needs of commercial customers, as well as federal and state agencies, including the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services.

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Ready for a new path? Start doing your life's best work. (sm)

Supervisor, Acute and Home Health Case Management provides front-line leadership to the Case Management staff. This department serves members across the continuum of care (inpatient/outpatient settings). The supervisor ensures polies and procedures are being followed by the front-line staff and measure the efficacy of their outcomes. The supervisor will implement business development opportunities to support growth and ensuring the program meets affordability goals. They will interact and collaborate with interdisciplinary care team; which includes a variety of healthcare professionals and clinicians.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Assisting with and developing process improvements within the department

  • Communicating and collaborating with external departments regarding contract needs

  • Act as a liasion with our customer

  • Communicating frequently with Medical Director regarding contract policies and procedures

  • Track and monitor department productivity

  • Work with training teams to ensure training initiatives are met and that trainees have necessary resources/tools to function in their role

  • Monitors department policy and procedure adherence

  • Monitors clinical guidance to ensure we are meeting contractual requirements

  • Cultivates a positive environment while supporting team member growth

  • Provide guidance to the Case Management staff to ensure program and utilization goals are met/exceeded

  • Measure employee performance and provide coaching and counseling to staff

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 and unrestricted RN license in the state you reside in

  • 3+ years of Utilization Review/Management experience

  • 3+ years of experience leading a multi-disciplinary team

  • Excellent written and verbal communication skill

  • Computer proficiency in MS Office: Outlook, Word, Excel, PowerPoint

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders.

Preferred Qualifications:

  • Bachelor’s and/or Master’s degree

  • Experience in managed care settings

  • Servant Leadership background

  • MedNet experience

  • Experience with ICD10 coding and medical terminology

  • Understanding of regulatory standards and contract requirements

  • Knowledge of analyzing and reporting statistical data

Careers with LHI. Our focus is simple. We're innovators in cost-effective health care management. And when you join our team, you'll be a partner in impacting the lives of our customers, and employees. We've joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We're located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We're supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. For you, that means one incredible team and a singular opportunity to do your life's best work.SM

Colorado Residents Only: The salary/hourly range for Colorado residents is $64,800 to $116,000 (add additional reference for sales and physicians). Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*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: Registered Nurse, RN, RN Case Manager, Utilization Manager, Utilization Review RN, Concurrent Review RN, Telecommute, Telecommuting, Work From Home, UM Nurse, CCR RN, Managed Care, case management, Telecommute, LHI