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Job Details


UnitedHealth Group

Market Health Services Director

Healthcare

All

Yearly

Full Time

No

Winston Salem, North Carolina, United States

Careers at Landmark, part of the Optum and UnitedHealth Group family of businesses. At Landmark, we work to deliver high quality, comprehensive care to chronically ill patients wherever they reside and whenever they need it. We focus on doing what’s right for the people we serve, even when it’s not easy. This is your opportunity to be part of a compassionate team that is setting out to change health care for complex, chronic patients. We’re looking for driven people like you because changing the status quo takes dedication. Here, we’ll invest in your personal and professional growth while giving you a unique opportunity to make a difference. Helping people feel their best is a rewarding part of doing your life’s best work.(sm)

Do you want to make a difference in healthcare?

Landmark Health was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to chronically ill patients, many of whom are ill-equipped to navigate our overwhelming healthcare system.

Because many of our patients are frail and elderly, we deliver care primarily in the comfort of their home. Our Program is also offered to eligible patients at no incremental financial cost to them. We are not a fee-for-service practice; we benefit economically only if we deliver high-quality patient outcomes and satisfaction. As a result, our clinical teams can spend quality-time caring for a smaller number of patients, giving all patients the space, respect, compassion and care they deserve.

At Landmark, our interdisciplinary teams collaboratively manage our complex patient panels. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers, Pharmacists, Behavioral Health, and other employed team members.

Join Landmark to be part of a growing company full of purpose-driven, action-oriented, and compassionate team members working to dramatically transform healthcare for our communities.

Objective:
This role serves as the market level operational lead for the clinical team. Reports to the local Executive Director and works closely with the local Regional Medical Director. Develops and implements strategy, policy and process to provide quality care and service to our patients.

The position oversees and ensures the effectiveness of the day-to-day operations of the clinical team regarding health plan coordination and communication, scheduling, quality metrics, engagement, geographic alignment of teams, interdisciplinary teams, quality programs, coordination of care, transitions of care, data collection/reporting and quality of care (list is not all inclusive). The position is responsible for relationships with vendors, facilities, health plan case management and health services, community-based providers and community organizations.

Primary Responsibilities:

  • Oversee and execute innovative models, processes, and programs/pilots in their market
  • Execute on changes to structure & policies
  • Execute on HP contract expectations and make sure market is meeting expectations
  • Implement national pilots in the market
  • Manages Clin Sups & SW Sups, has regular 1:1s & manages QPUs
  • 1:1s with their Regional HSD
  • Manages QIP and QIP exceptions as well as ADP/PTO/concur request
  • Executes on standardized processes in mkt
  • Accountable for market outcomes (PDV, Quality, UEOC, performance metrics, etc.)
  • Reviews market reporting and takes appropriate action (deploys IDT staff effectively, trains, educates, audits, etc.)
  • Implements markets on clinical
  • Recruiting, training, performance management and retention of the interdisciplinary team members
  • Maintains quality of services through audits and education
  • Oversees the management of the day-to-day operations of the clinical team in the market
  • External health care facility & vendor relationships (home health agencies, etc.
  • Oversees hospice reporting and performance and collaborating with RMds on this
  • Execute process changes
  • Provides oversight, guidance on using data to manage market
  • Oversees processes for inventory of medical supplies, PPE, Supply Closet
  • Executing adherence to health service policies
  • Aggregating and managing market complaints and grievances
  • Managing the medical record request process (disability, PCP, HP etc.)
  • Attend and actively participate in targeted contracted health plan IDT, Clinical Operations, JOC’s and other operational meetings as needed
  • Relationship management with second/third tier IPAs, Targeted HPs and Community PCP in market
  • Joins the Quality Management program for the market and raise up updated to regional HSD
  • Executes and managing on Quality Measure processes (i.e. ensures that documentation is completed by providers and IDT members timely and accurately and quality gaps are managed)
  • On Point for Market QBR prep, material creation, and report-out with Regional and Division Leadership

Supervisory:
Reports directly to the local Executive Director

Competency:
To perform the job successfully, an individual should demonstrate the following competencies:

  • Problem Solving - Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics
  • Technical Skills - Assesses own strengths and weaknesses; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others
  • Interpersonal Skills - Focuses on solving conflict; maintains confidentiality; listens to others; keeps emotions under control and overcomes resistance when necessary; remains open to new ideas
  • Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and seeks clarification; responds openly to questions. Must be able to deal with frequent change, delays, or unexpected events
  • Attendance/Punctuality - Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time
  • Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate plan
  • Initiative - Volunteers readily; undertakes self-development activities; seeks increased responsibilities; takes independent actions and calculated risks; looks for and takes advantage of opportunities; asks for and offers help when needed; generates suggestions for improving work and workflow


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:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

  • Current RN License
  • 5+ years of clinical practice in a hospital, clinic, home care, or nursing home setting
  • 5+ years of increasing supervisory or management experience in a health care setting

Preferred Qualifcations:

  • BSN, MBA or Business experience
  • Case management experience
  • Disease and utilization management experience
  • Physician office experience

Physical Demands:

Below are the physical requirements which are representative of those that must be met by the employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

  • Regular requirement to sit; use hands to touch, handle or feel
  • Regular requirement to talk and listen
  • Occasional requirement to stand; walk and reach with hands and arms
  • Occasional requirement to lift and/or move up to 10 pounds
  • Vision abilities include close vision, peripheral vision, depth perception and ability to adjust focus

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 with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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.