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UnitedHealth Group Registered Nurse RN Clinical Integration Manager WellMed Houston Texas in Gonzales, Texas

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s bestwork.(sm)

This position has significant local and non-local travel throughout Texas

The Clinical Integration Implementation Manager (CIIM) focuses on the training and implementation of clinical policies, procedures, processes, and operating guidelines of the WellMed organization. Carries out the approved project plan established for integration, maintaining all budget and time restraints. The CIIM will work closely with operational partners, including corporate education and support department teams, to provide successful clinic and/or market integration. The Clinical Integration Implementation Manager will provide support for clinical due diligence activities as assigned.

Primary Responsibilities:

  • Completes Population Management and Processes training and implementation

  • Completes Functional Patient Care Committee training and implementation

  • Implements QRA processes and initiatives

  • Implements Medical Management and Utilization Management processes and training

  • Facilitates patient satisfaction improvement processes with the integrations clinics

  • Identifies variances in operational structure and function between current and desired state

  • Engages appropriate resources to provide training, tools and support to clinic and/or market team to reach desired stated as it relates to clinical processes

  • Provides support and serves as on-going resource to the clinic and/or market team to ensure performance targets are met, with a focus on quality and risk adjustment goals

  • Identifies risk issues that impact successful integration of the clinic and/or m and engages proper resources to ensure resolution as it relates to clinical processes

  • Ensures engagement of entire market team in successful transition of the clinic and/or market onboarding to the defined desired state

  • Ensures integration timelines are met in accordance with the approved project plan

  • Maintains and builds relationships across business groups

  • Assists clinic staff and/ or market team in defining appropriate workflows based on introduction of new clinical processes

  • Provides input into engagement decisions, including work plan, timeline and resource allocation as it relates to clinical work flows

  • Completes Practice Health and Safety Assessments as assigned

  • Completes Medical Chart Reviews as assigned

  • Performs all other related duties as assigned

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:

  • Active unrestricted Registered Nurse (RN) license in the applicable state of employment

  • Bachelor’s degree in Nursing, Healthcare or Business Administration or a related field required. (6 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor’s degree)

  • 4+ years in the healthcare field, with an emphasis in clinic operations or staff training and development

  • Strong interpersonal skills with ability to interface effectively both externally and internally with a wide range of people including physicians, office staff and other health plan staff

  • Knowledge of organization policies and procedures and ability to read, interpret and apply

  • Knowledge of and skills with tools used in Healthcare Operations: EMR, Practice Management System, Clinic Operations and related systems

  • Significant travel required approximately 75% travel time

Preferred Qualifications:

  • 6+ years of directly related experience in medical practice management

  • Supervisory experience in a healthcare setting

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 350,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

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.

Job Keywords: WellMed, Healthcare, Bilingual, Registered Nurse, RN, Clinical Integration Manager, CIM, travel required, Houston, Galveston, Harris, Fort Sam, Beaumont Texas, TX