TRICARE Supervisor, Inpatient Utilization Management - Hawaii (504816)
UnitedHealth Group - Hawaii

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UnitedHealthcare Military and Veterans is currently seeking a Clinical Supervisor for our Inpatient Utilization Management Programs in an integrated Medical and Behavioral Management organization. In these roles, you will be is responsible to provide oversight and leadership to a team of Utilization Management staff which includes developing a solid team structure that promotes teamwork, learning, and employee job satisfaction while achieving Company and Department vision, values and goals.

Primary responsibilities:
• Overall responsibility for the supervision and coordination of all workflow activities related to Inpatient Utilization Management

• Provides clinical expertise to the team nursing and support staff.

• Provides mentorship and training for team members

• Represents the department in assigned Plan committees/meetings.

• Assists with the development and implementation of departmental policies and procedures.

• Compliance with all Tricare regulatory requirements

• Sets team direction, resolves problems and provides guidance to members of their own team.

• Ensures team meets established performance metrics and Tricare regulatory requirements.

• Re-educate, coach and counsel staff when indicated.

• Audit activities to assure policies and procedures are understood and implemented and service is delivered according to internal and customer standards

• Collaborates with the VP of Utilization Management to review compliance data, develop and implement strategy

Qualifications

• Registered Nurse with an active license

• Previous Inpatient Utilization Management experience

• 2+ years of

Management or Business Operation experience

• 3+ years of Leadership experience to include staff oversight, performance management

• United States Citizenship

• Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86.

• BS or BSN required

• Demonstrated strong computer skills including the ability to navigate a Windows environment and at least basic skills with MS Word and MS Excel

• Strong organizational and communication skills

Preferred Qualifications:
• Previous Inpatient Utilization Management experience

• Demonstrated experience developing workflows or implementing process improvements to gain operational efficiencies

• Proven history of driving operational performance and achieving established metrics

• Excellent communication skills with the ability to interrelate with individuals at various levels

•Ability to develop effective business relationships across business and product teams

•Prior experience leading and participating in cross functional and interdisciplinary teams

•Bilingual

•Military Service

•Experience working in health care with military populations

As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 http://www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or “NAC”).

Successful completion of the NAC process is a requirement for continued employment in this role.

NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense.

Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received.

Failure to obtain final NAC approval will result in termination from this role.

Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That’s why UnitedHealthcare is the organization that’s called on to serve them and their loved ones. We’re all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It’s a genuine opportunity to do your life’s best work.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

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