Remote RN Clinical Manager – Managed Care Lead

NHSHP; El Paso (TX); Hybrid; USD 92,000 - 164,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group is seeking a Service Coordination Manager, RN, to oversee service coordination staff and drive policy implementation for Star+Plus and LTSS, improving timeliness and outcomes.

The role requires a Texas RN license, 7+ years in healthcare with 2+ years in managed care, and 3+ years in management. Bilingual English/Spanish, strong communication, and leadership are essential; remote work is possible within commuting distance of El Paso, TX with up to 40% travel.

Qualifications

• Graduate of an accredited school of nursing.
• Current unrestricted RN license in Texas.
• 7+ years of experience in healthcare with 2+ years in managed care.
• 3+ years of management or supervisory experience in managed care.
• Hands-on experience with STAR+PLUS and LTSS program operations and service delivery.
• Experience with electronic charting and review.
• Proficiency in Windows environment including Word, Excel, and Outlook.

Responsibilities

• Provide supervision and oversight of service coordination staff.
• Participate in interdepartmental meetings to represent service coordination needs.
• Facilitate orientation and training of service coordination staff and provide feedback.
• Establish goals for performance standards of service coordinators.
• Provide ongoing training and development of staff to achieve performance standards.
• Identify problems/barriers/opportunities and intervene with plans.
• Provide analysis and reporting to ensure compliance with HHSC, TDI, UMCC and URAC standards.
• Manage field staff productivity goals, member satisfaction and outcomes measures.
• Conduct ride-along and telephonic auditing to support staff evaluation.
• Develop and maintain corrective action plans.

Skills

Leadership

Communication

Bilingual EN/ES

Nursing license

Case management

Healthcare experience

Managed care

Travel up to 40%

Clinical leadership

Education

Nursing degree

RN license Texas

Bachelor's degree (preferred)

Job description

UnitedHealth Group is seeking a Service Coordination Manager, RN, to oversee service coordination staff and drive policy implementation for Star+Plus and LTSS, improving timeliness and outcomes.

The role requires a Texas RN license, 7+ years in healthcare with 2+ years in managed care, and 3+ years in management. Bilingual English/Spanish, strong communication, and leadership are essential; remote work is possible within commuting distance of El Paso, TX with up to 40% travel.