APC Manager - Clinical Services - New Jersey - Optum
Company: Optum
Location: Basking Ridge
Posted on: September 12, 2024
Job Description:
Optum Home & Community Care, part of the UnitedHealth Group family
of businesses, is creating something new in health care. We are
uniting industry-leading solutions to build an integrated care
model that holistically addresses an individual's physical, mental
and social needs - helping patients access and navigate care
anytime and anywhere. - - -
- -
As a team member of our Senior Community Care (SCC) product, we
work with a team to provide care to patients at home in a nursing
home, assisted living for senior housing. This life-changing work
adds a layer of support to improve access to care. -
- -
We're connecting care to create a seamless health journey for
patients across care settings. Join us to start Caring. Connecting.
Growing together. -
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We're fast becoming the nation's largest employer of Nurse
Practitioners; offering a superior professional environment and
incredible opportunities to make a difference in the lives of
patients. This growth is not only a testament to our model's
success but the efforts, care, and commitment of our Nurse
Practitioners.
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The Sr. CSM role will be instituted according to Optum CCM Model
office guidelines. The Sr. CSM in collaboration with market DCO
provides leadership and is accountable for the performance of a
team of CSM's as well as a team of Advanced Practice Clinicians
(APC's). In collaboration with the DCO, the Senior CSM will
strategize, develop, and direct operations of the clinical
department to ensure the provision of high quality and
cost-effective medical services are delivered to membership.
The Sr. CSM will:
- Assist in the development of functional market level
strategies, plans, and organizational priorities
- Identify and resolve technical, operational and organizational
challenges outside and within clinical team
- develops internal and external strategic relationships, which
support program expansion and continuing success
- Directly manage clinical staff to ensure business goals/metrics
are achieved
-
Primary Responsibilities:
- Communication and Relationships:
- Leadership Adeptness: Staff Performance, Retention and
Development
- Manage salary, bonus incentives, and enforce work rules in a
manner that rewards excellent performance, and maximizes staff
retention while meeting budget requirements
- Directly lead, supervise, and develop a team of CSM's as well
as team of APC's
- Maintain overall accountability for clinical team development
and performance
- Direct the orientation, training and ongoing education and
skill development of the clinical team
- Conduct regular agenda driven meetings with staff to address
issues, concerns, and to communicate corporate and site-specific
philosophy
- Promotes United culture to ensure succession planning
- Business Skills/Healthcare Environment:
- Revenue Accuracy and Medical Management
- Lead the medical expense data analyses
- Determine required improvement efforts for the site, based on
outcomes relative to targets and budgeted matrices in collaboration
with DCO and Medical Director
- Work in collaboration with DCO to strategize and implement the
clinical model -
- Focus on quality improvement and clinically appropriate
utilization, while incorporating the skills of provider
partners
- Oversee the integrity of the patient-data base system to ensure
consistency in the data entry and integrity
- Internal and External Strategic Partnerships:
- In collaboration and under the direction of the DCO Implement a
program to address the needs of the marketplace-area
- Assist DCO to strategize and evaluate methodologies for program
adaptation and integration within partnering organizations
- Conduct regular agenda-driven meetings with selected partners
to promote program visibility, and to support a dynamic,
results-oriented relationship with selected organizations,
contracted facilities, or associated consortium or corporation
-
- In collaboration with the DCO and Medical Director strategize
with the senior staff regarding:
- Program expansion
- Business development
- New models
- Clinical Adeptness:
- Program Quality:
- In collaboration with DCO develops well-designed processes,
which will be evident in efficient daily workflows that support the
achievement of business goals and improve quality of care, work
efficiency, and job satisfaction of the clinical team -
- Assist the DCO in directing the integration of the local
quality assurance committee activities -
- Ensure compliance with State and Federal regulations, company
policies, and procedures -
- Identify any quality issues and implement quality initiatives
for improvement -
- Use reports and other available materials to analyze
performance & gaps (know your numbers) - -
- Develop & support implementation of corporate & local processes
to support QI and to achieve business goals -
- Identify system level opportunities to support QI -
- Provide clinical support and education -
- Hold team responsible for progress in prioritized areas
-
- Share best practices across the organization through
participation on workgroups -
- Professionalism:
- Personal and Professional Accountability:
- Create an environment that facilitates the team to initiate
actions that produce positive results -
- Ability to hold self and others accountable for actions and
results -
- Answers for one's own behavior and actions -
- Career Planning:
- Develops own career path -
- Coach others in the development of their career planning
-
- Create an environment in which professional and personal growth
are an expectation -
- Ethics:
- Integrate high ethical standards and UHG core values into
everyday work activities -
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:
- Certified Nurse Practitioner or Physician Assistant through a
national board
- For NPs: Graduate of an accredited Master's degree in Nursing
(MSN) program or Doctor of Nursing practice (DNP) program and board
certified through the American Academy of Nurse Practitioners
(AANP) or the American Nurses Credentialing Center (ANCC),
Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP),
Adult/Family or Gerontology Nurse Practitioners (ACNP), with
preferred certification as ANP, FNP, or GNP -
- For PAs: Graduate of an accredited Physician Assistant degree
program and currently board certified by the National Commission on
Certification of Physician Assistants (NCCPA) -
- Active and unrestricted license in the state which you reside
-
- Current active DEA licensure/prescriptive authority or ability
to obtain post-hire, per state regulations (unless prohibited in
state of practice) -
- 3+ years of experience as an APC, demonstrating progressive
responsibility -
- Access to reliable transportation that will enable you to
travel to client and/or patient sites within a designated area
-
- Ability to lift a 30-pound bag in and out of car and to
navigate stairs and a variety of dwelling conditions and
configurations -
- Ability to gain a collaborative practice agreement, if
applicable in your state
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Preferred Qualifications:
- 3+ years of previous management experience -
- 2+ years of leadership and management experience in an
organization that serves the chronically ill -
- 2+ years of Medicare experience
- 1+ years of hands-on post grad experience -
- 1+ years of experience as a CSM at Optum
- Leadership and management experience in a CCM market as a CSM
with success in effective team building and quality improvement
-
- Ability to quickly adapt to change and drive change management
within team and market -
- Possesses a high level of organizational skills, self-
motivation, and ability to manage time independently -
- Proficient computer skills including the ability to document
medical information with written and electronic medical records
-
- Proficient in MS Excel
- Possess knowledge and understanding of geriatrics clinical
management -
- Ability to develop and maintain positive customer
relationships
- Ability to work across functions and businesses to achieve
business goals -
- Effective in motivating and mentoring colleagues and peers
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New Jersey Residents Only: The salary range for this role is
$104,700 to $190,400 annually. Pay is based on several factors
including but not limited to local labor markets, education, work
experience, certifications, etc. UnitedHealth Group complies with
all minimum wage laws as applicable. In addition to your salary,
UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice
of benefits and incentives.
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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.
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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.
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UnitedHealth Group is a drug-free workplace. Candidates are
required to pass a drug test before beginning employment
Keywords: Optum, Plainfield , APC Manager - Clinical Services - New Jersey - Optum, Executive , Basking Ridge, New Jersey
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