UnitedHealth Group
Clinical Manager Care Coordinator - Metairie, LA - 2327002
UnitedHealth Group, Metairie, Louisiana, us, 70011
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start
Caring. Connecting. Growing together.
The Clinical Manager of Care Coordination oversees daily operations for both Special Needs Plan (SNP) and Non‑SNP care coordination teams. This role ensures effective planning, assessment, care planning, and follow‑up for all member populations. The manager supports compliance with clinical policies, regulatory requirements, and provides staff training and development. Additionally, the manager supports the Director of Clinical and Systems Operations by contributing to strategic initiatives, systems integration and data‑driven decision‑making to enhance care coordination and operational efficiency.
Provides leadership and oversight of staff engaged in care coordination and case management for both SNP and Non‑SNP members. Ensures adherence to the Model of Care, CMS regulations, and internal policies. Collaborates with the Director to align clinical operations with strategic goals and systems improvements. Manages RN Care Coordinators to ensure quality, compliance, and member‑centered care delivery.
If you reside within a commutable distance of Metairie, LA, you'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
Improve health care quality and increase the likelihood of desired health outcomes
Facilitates communication and coordination between all members of the health care team
Provides clinical guidance in matters of assessment, care planning, documentation, provision of services, and care coordination
Participates in evaluations of the quality and effectiveness of assessment and care planning for population based on risk status
Monitors and analyzes HEDIS and Star measures
Audit staff documentation and care planning for quality and compliance
Support wellness and health promotion initiatives
Prevention and utilization
Monitors performance on identifying and coordinating benefit options for the member and/or care giver to overcome potential barriers to prevent hospitalization and/or readmission
Monitors performance against assigned member's gaps in HEDIS and Star measures through weekly report analysis
Provide and support wellness and health promotion activities
Collaborates and facilitates with members of internal/external interdisciplinary care teams and medical director(s) to facilitate appropriate treatment for members
Promotes utilization of evidence‑based guidelines in daily practice
Provides leadership, assists with ongoing evaluation of programs and staff compliance
Completes documentation of staff performance of assigned staff
Provides continuing education and coaching to staff
Support health information technology (HIT) in health care quality improvement
Works in coordination company‑based security health information systems technology to ensure appropriate documentation of the member's care coordination and record
Participates in ongoing training to ensure the records are accurate and secure
Follows corporate instruction based on Federal and State guidance related to health information documentation and security
Support the Director in systems integration projects and workflow improvements
Assist in maintaining training manuals and documentation for clinical systems
Strategic & Operational Support
Provides input to the Director on clinical trends, gaps, and improvement opportunities
Increases and maintains personal proficiency and use of systems, reports, metrics, etc. as a managerial responsibility
Assists in analyzing clinical data and operational metrics
Collaborates with IT, Claims, and other departments to support workflow enhancements
Champion of change and promotes a culture of acceptance and positivity with process and program changes
Participates in cross‑functional initiatives to enhance care delivery and system design
Takes an active interest and ownership of projects assigned by the Clinical Director
Collaborates with leadership and is an active participant in program process change/updates and implementation
Uses effective critical thinking skills by evaluating information against current processes, policies, and procedures in order to utilize the most beneficial actions for the member and organization
Cultivate team engagement and create high performing teams to advance our mission and serve our customers and patients
Implement solid team routines including 1:1s and team meetings to provide direction and clarify priorities
Provides feedback to the Director on team status including but not limited to barriers, success, and identified staffing issues
Keeps the Director in the know of all side projects and routinely reports updates on projects assigned as well as projects the employee is an active participant in across the organization
Management Responsibilities
Monitors both department and individual staff performance, providing ongoing feedback
Maintains appropriate staffing levels required to meet departmental goals
Interviews candidates and makes hiring decisions as needed
Identifies opportunities for staff development and coordinates training as needed
Ensures staff members meet all required licensing, compliance and Compliance Wire requirements
Completes timely and thorough evaluations of staff
Functions as a mentor to staff regarding career goals within Peoples Health
Proactively manages employee relations issues, utilizing a progressive corrective action plan including appropriate documentation
Serves as a resource to other managers regarding issues that impact their departments
Develops, manages and works within department budget
Ensures compliance by maintaining knowledge of industry trends and legislation related to department
Ensures timely review and updating of departmental policies, procedures, training manuals and job descriptions as needed
Supervisory Responsibilities
Manages the daily work flow and operations of department including ensuring appropriate coverage
Handles escalated operational issues as needed and knows when to involve management
Assists Clinical Director of Non‑SNP Care Coordination in identifying appropriate staffing levels required to meet departmental goals
Identifies opportunities for staff development and works with management to coordinate/provide training as needed
Assists with development and maintenance of department training manuals
Plays an active role in staff training/development initiatives
Provides input to management regarding employees' strengths and necessary improvement
Serves as a resource to staff and Clinical Director of Non‑SNP Care Coordination regarding issues that impact their department
Reports to the Clinical Director of Non‑SNP Care Coordination and has the management responsibilities of the staff to include:
Care Coordinator - Registered Nurse
Administrative Assistant/Clerical Support
Other staff as assigned
Peoples Health Competencies
Commitment: to our Members: We have the power to change our members' lives by placing them at the center of everything we do daily
Action: By working together and delivering quality service, we enhance the lives of our members through dedication and teamwork
Responsibility: To continue to strive to be the best for our members by adapting and evolving to change, continuing professional development, and to never stop learning
Excellence: By exceeding expectations and finding innovative ways to exceed standards, we are changing our members' lives
Management Core Competencies
Leadership – inspires and motivates others to perform well; leads by example
Negotiation and Influential Ability – influences decisions in matters related to department to ensure corporate and departmental needs are satisfied
Management skills – includes staff in planning, decision‑making, facilitating and process improvement; makes oneself available to staff, provides regular feedback and develops staff's skills – encouraging growth
Analytical/problem solving skills – identifies and resolves problems in a timely manner and gathers and analyzes information skillfully
Judgment – displays willingness to make decisions, exhibits sound and accurate judgment and makes timely decisions
Planning/organizational skills – prioritizes and plans work activities, uses time efficiently and develops realistic action plans
Oral/written communication skills – speaks and writes clearly and persuasively in positive or negative situations. Demonstrates group presentation skills when conducting meetings, leading a team or working with peers
Additional Competencies
Professionalism
Prompt and dependable
Sound clinical judgement, assessment, planning and care coordination skills
Expert skills in assessing clinical data and drawing conclusions
Ability to comprehend and adhere to policies and procedures
Expert skills in assessing clinical data and drawing conclusions
Ability to comprehend and adhere to policies and procedures
Expert skills in interviewing, assessing, and communicating effectively with members who have varying levels of education
Positive attitude related to change and the ability to easily adapt
Display a high level of integrity and respect for confidentiality and adhere to regulatory and PH policies and procedures
Solid interpersonal, planning, organizational, communication, and decision‑making skills
Ability to collaborate effectively with others in planning, problem solving, and completing work assignments
Exceptional attention to detail
Ability to meet deadlines under pressure
Ability to effectively direct staff, manage conflict and resolve issues
Manages time appropriately, efficiently, and effectively
Ability to read, comprehend, and apply information written at a college level
Appreciation for diversity of work styles
Effective listener
Ability to effectively interact with multifaceted medical professional 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
RN Diploma or Degree is required in LA
3+ years of experience in clinical or similar setting
Experience with clinical documentation systems
Experience in assessing members and developing care plans
Proficient with MS Office (Excel, MS Word and PowerPoint)
Reside within a commutable distance of Metairie, LA
Preferred Qualifications
Bachelor's Degree in Nursing
Multi‑state/compact license
1+ years supervisory experience
Experienced in management care industry
Familiarity with NCQA structure and process measures and CMS Medicare managed care regulations
Understanding of HMO and third‑party administration
Continuing education in the healthcare/managed care industry
Solid organizational skills, attention to detail, verbal and written communication skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far‑reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full‑time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone‑of every race, gender, sexuality, age, location and income‑deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
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Caring. Connecting. Growing together.
The Clinical Manager of Care Coordination oversees daily operations for both Special Needs Plan (SNP) and Non‑SNP care coordination teams. This role ensures effective planning, assessment, care planning, and follow‑up for all member populations. The manager supports compliance with clinical policies, regulatory requirements, and provides staff training and development. Additionally, the manager supports the Director of Clinical and Systems Operations by contributing to strategic initiatives, systems integration and data‑driven decision‑making to enhance care coordination and operational efficiency.
Provides leadership and oversight of staff engaged in care coordination and case management for both SNP and Non‑SNP members. Ensures adherence to the Model of Care, CMS regulations, and internal policies. Collaborates with the Director to align clinical operations with strategic goals and systems improvements. Manages RN Care Coordinators to ensure quality, compliance, and member‑centered care delivery.
If you reside within a commutable distance of Metairie, LA, you'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
Improve health care quality and increase the likelihood of desired health outcomes
Facilitates communication and coordination between all members of the health care team
Provides clinical guidance in matters of assessment, care planning, documentation, provision of services, and care coordination
Participates in evaluations of the quality and effectiveness of assessment and care planning for population based on risk status
Monitors and analyzes HEDIS and Star measures
Audit staff documentation and care planning for quality and compliance
Support wellness and health promotion initiatives
Prevention and utilization
Monitors performance on identifying and coordinating benefit options for the member and/or care giver to overcome potential barriers to prevent hospitalization and/or readmission
Monitors performance against assigned member's gaps in HEDIS and Star measures through weekly report analysis
Provide and support wellness and health promotion activities
Collaborates and facilitates with members of internal/external interdisciplinary care teams and medical director(s) to facilitate appropriate treatment for members
Promotes utilization of evidence‑based guidelines in daily practice
Provides leadership, assists with ongoing evaluation of programs and staff compliance
Completes documentation of staff performance of assigned staff
Provides continuing education and coaching to staff
Support health information technology (HIT) in health care quality improvement
Works in coordination company‑based security health information systems technology to ensure appropriate documentation of the member's care coordination and record
Participates in ongoing training to ensure the records are accurate and secure
Follows corporate instruction based on Federal and State guidance related to health information documentation and security
Support the Director in systems integration projects and workflow improvements
Assist in maintaining training manuals and documentation for clinical systems
Strategic & Operational Support
Provides input to the Director on clinical trends, gaps, and improvement opportunities
Increases and maintains personal proficiency and use of systems, reports, metrics, etc. as a managerial responsibility
Assists in analyzing clinical data and operational metrics
Collaborates with IT, Claims, and other departments to support workflow enhancements
Champion of change and promotes a culture of acceptance and positivity with process and program changes
Participates in cross‑functional initiatives to enhance care delivery and system design
Takes an active interest and ownership of projects assigned by the Clinical Director
Collaborates with leadership and is an active participant in program process change/updates and implementation
Uses effective critical thinking skills by evaluating information against current processes, policies, and procedures in order to utilize the most beneficial actions for the member and organization
Cultivate team engagement and create high performing teams to advance our mission and serve our customers and patients
Implement solid team routines including 1:1s and team meetings to provide direction and clarify priorities
Provides feedback to the Director on team status including but not limited to barriers, success, and identified staffing issues
Keeps the Director in the know of all side projects and routinely reports updates on projects assigned as well as projects the employee is an active participant in across the organization
Management Responsibilities
Monitors both department and individual staff performance, providing ongoing feedback
Maintains appropriate staffing levels required to meet departmental goals
Interviews candidates and makes hiring decisions as needed
Identifies opportunities for staff development and coordinates training as needed
Ensures staff members meet all required licensing, compliance and Compliance Wire requirements
Completes timely and thorough evaluations of staff
Functions as a mentor to staff regarding career goals within Peoples Health
Proactively manages employee relations issues, utilizing a progressive corrective action plan including appropriate documentation
Serves as a resource to other managers regarding issues that impact their departments
Develops, manages and works within department budget
Ensures compliance by maintaining knowledge of industry trends and legislation related to department
Ensures timely review and updating of departmental policies, procedures, training manuals and job descriptions as needed
Supervisory Responsibilities
Manages the daily work flow and operations of department including ensuring appropriate coverage
Handles escalated operational issues as needed and knows when to involve management
Assists Clinical Director of Non‑SNP Care Coordination in identifying appropriate staffing levels required to meet departmental goals
Identifies opportunities for staff development and works with management to coordinate/provide training as needed
Assists with development and maintenance of department training manuals
Plays an active role in staff training/development initiatives
Provides input to management regarding employees' strengths and necessary improvement
Serves as a resource to staff and Clinical Director of Non‑SNP Care Coordination regarding issues that impact their department
Reports to the Clinical Director of Non‑SNP Care Coordination and has the management responsibilities of the staff to include:
Care Coordinator - Registered Nurse
Administrative Assistant/Clerical Support
Other staff as assigned
Peoples Health Competencies
Commitment: to our Members: We have the power to change our members' lives by placing them at the center of everything we do daily
Action: By working together and delivering quality service, we enhance the lives of our members through dedication and teamwork
Responsibility: To continue to strive to be the best for our members by adapting and evolving to change, continuing professional development, and to never stop learning
Excellence: By exceeding expectations and finding innovative ways to exceed standards, we are changing our members' lives
Management Core Competencies
Leadership – inspires and motivates others to perform well; leads by example
Negotiation and Influential Ability – influences decisions in matters related to department to ensure corporate and departmental needs are satisfied
Management skills – includes staff in planning, decision‑making, facilitating and process improvement; makes oneself available to staff, provides regular feedback and develops staff's skills – encouraging growth
Analytical/problem solving skills – identifies and resolves problems in a timely manner and gathers and analyzes information skillfully
Judgment – displays willingness to make decisions, exhibits sound and accurate judgment and makes timely decisions
Planning/organizational skills – prioritizes and plans work activities, uses time efficiently and develops realistic action plans
Oral/written communication skills – speaks and writes clearly and persuasively in positive or negative situations. Demonstrates group presentation skills when conducting meetings, leading a team or working with peers
Additional Competencies
Professionalism
Prompt and dependable
Sound clinical judgement, assessment, planning and care coordination skills
Expert skills in assessing clinical data and drawing conclusions
Ability to comprehend and adhere to policies and procedures
Expert skills in assessing clinical data and drawing conclusions
Ability to comprehend and adhere to policies and procedures
Expert skills in interviewing, assessing, and communicating effectively with members who have varying levels of education
Positive attitude related to change and the ability to easily adapt
Display a high level of integrity and respect for confidentiality and adhere to regulatory and PH policies and procedures
Solid interpersonal, planning, organizational, communication, and decision‑making skills
Ability to collaborate effectively with others in planning, problem solving, and completing work assignments
Exceptional attention to detail
Ability to meet deadlines under pressure
Ability to effectively direct staff, manage conflict and resolve issues
Manages time appropriately, efficiently, and effectively
Ability to read, comprehend, and apply information written at a college level
Appreciation for diversity of work styles
Effective listener
Ability to effectively interact with multifaceted medical professional 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
RN Diploma or Degree is required in LA
3+ years of experience in clinical or similar setting
Experience with clinical documentation systems
Experience in assessing members and developing care plans
Proficient with MS Office (Excel, MS Word and PowerPoint)
Reside within a commutable distance of Metairie, LA
Preferred Qualifications
Bachelor's Degree in Nursing
Multi‑state/compact license
1+ years supervisory experience
Experienced in management care industry
Familiarity with NCQA structure and process measures and CMS Medicare managed care regulations
Understanding of HMO and third‑party administration
Continuing education in the healthcare/managed care industry
Solid organizational skills, attention to detail, verbal and written communication skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far‑reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full‑time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone‑of every race, gender, sexuality, age, location and income‑deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.
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