Supervisor, Case Management - Albuquerque, New Mexico

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

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:
  • Functions as a hands-on supervisor, coordinating and monitoring clinical and non-clinical team activities to facilitate integrated, proactive case management (CM), ensuring compliance with regulatory and accrediting standards
  • Oversees an integrated team responsible for complex case management, disease management, care coordination, and population health management
  • Manages and evaluates teammates including remote-based teammates in the performance of various CM activities; provides coaching, counseling, employee development, and recognition; and assists with selection, orientation and mentoring of new team members
  • Ensures that teammates complete quality audit reviews
  • Performs and promotes interdepartmental integration and collaboration to facilitate the continuity of care including transitions of care
  • Maintains adequate staffing, service levels and customer satisfaction by implementing and monitoring teammate productivity and other performance indicators
  • Reports on CM statistics including teammate productivity, cost effective utilization of services, management of targeted member population, referrals to case management and triage activities
  • Evaluates services provided and outcomes achieved and recommends enhancements/improvements for programs and team development to ensure consistent cost effectiveness and compliance with all state and federal regulations and guidelines including HIPAA
  • Maintains professional relationships with provider community and internal and external customers while identifying opportunities for improvement
  • Communicates with management regarding development within areas of assigned responsibilities and works on special projects as required
  • Identifies and addresses opportunities for quality improvement in all aspects of serving our customers
  • Assists in planning and implementation of systems changes and procedures to achieve overall organizational objectives
  • Other duties as assigned


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:
  • Associates Degree in Nursing
  • 3+ years of experience providing case management functions within health plan OR integrated system with one 1+ years of supervisory experience
  • Valid NM RN License
  • Travel between offices and facilities for training and meetings


Preferred Qualifications:
  • Bachelor's Degree in Nursing
  • Knowledge of HMO's, PPO's, Medicare, Medicaid, and insurance plans
  • Knowledge of CPT4/ICD 9 & 10/HCPCS codes
  • Ability to communicate and interact professionally with co-workers, management patients, and providers
  • Ability to counsel and/or consult
  • PC proficient


UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

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: Spvsr Case Mgmt, Nursing, Albuquerque, NM, New Mexico, Supervisor, Case Management

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