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Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting with a focus on LTC.  Function may also be responsible for providing health education, coaching and treatment decision support for care coordination staff. 

This position provides leadership to and is accountable for the performance of managers and/or senior level professional staff. Impact of work is most often at the operational or local business unit or market level. Requires current unrestricted RN, Social Worker or Psychologist licensure in applicable state.

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

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.

Primary Responsibilities:

• Leadership of LTSS teams across the state
• Ensure compliance with state, federal and NCQA regulations/guidelines
• Leverage clinical acumen to provide guidance to staff on complex cases
• Provide oversight and review of coordination of care (e.g. chronic condition management, utilization management and case management)
• Achieve affordability targets through Nursing Home Diversion and Repatriation programs
• Cultivate and deepen relationships with HCBS providers and state partner
• Process improvement
• Implementation of new programs/processes

Required Qualifications:

• Undergraduate degree or equivalent experience
• Unrestricted RN, Social Work or Psychology license in the state of Kansas
• 5+ years of experience in Leadership/Management of staff
• 5+ years of experience in Case Management 
• 5+ years of experience presenting to senior leaders and external stakeholders
• 3+ years of experience with Care Management system implementations and or upgrades
• Extensive experience with Policy and SOP development  
• Excellent writing skills 
• Intermediate-Advanced Microsoft Office suite to include, Word, Excel, PowerPoint

Preferred Qualifications:

• Master’s degree
• Medicaid Managed care experience
• Long Term Care knowledge/experience including HCBS Waivers
• Experience with monitoring and improving clinical compliance 
• Experience with end to end process improvement 

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 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.