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UnitedHealth Group - Floresville, TX
posted 2 months ago
About the position
The Enterprise Clinical Consultant at WellMed, part of the Optum family, is responsible for managing and supervising all Homecare Dimensions Clinical Programs in Texas. This role focuses on implementing performance improvement activities, maintaining regulatory standards, and ensuring quality patient care. The consultant will oversee daily operations, staff recruitment, and development, while also managing patient needs and financial objectives to contribute to the branch's success.
Responsibilities
- Directs the daily operations of Clinical Programs/Operations to ensure safe, quality, cost-effective care to patients.
- Regularly evaluates services and care provided by the branch for compliance with regulatory requirements and company policies.
- Directs recruitment, hiring, and development of clinical and non-clinical staff for consistent quality care.
- Assures clinical caregivers perform accurate assessments and communicate effectively with physicians.
- Manages staff assignments and schedules, ensuring caregiver qualifications match patient needs.
- Participates in care coordination activities to address patient/client needs and concerns.
- Ensures patient/client clinical records meet legal and regulatory requirements.
- Develops knowledge of services and resources available within the company and community.
- Interfaces with intake to ensure appropriate patient/client admissions for clinical services.
- Conducts annual evaluations of staff according to policies and regulations.
- Supervises clinical and operational processes, ensuring effective communication and documentation.
- Provides support for reimbursement documentation.
- Assists in developing annual market assessments, budgets, and business plans.
- Gathers information on marketplace pay and bill rates for business opportunities.
- Schedules staff meetings to communicate updates and concerns regarding patient/client care.
- Identifies operational issues that may compromise service quality.
- Implements marketing efforts to support new and existing programs.
- Maintains Quality Assurance Performance Improvement for the branch.
- Collects data for root-cause analysis to identify improvement opportunities.
- Oversees branch operations and adjusts for efficiency.
- Investigates complaints and incidents, ensuring appropriate resolutions.
- Submits reports by deadlines and provides backup support as needed.
Requirements
- Bachelor's degree in health or business administration (or equivalent work experience).
- Registered Nurse with 6+ years of clinical leadership/management experience.
- Recent experience in acute care or home care within the last 2 years.
- Knowledge of governmental home health agency regulations and Medicare/Medicaid policies.
- Strong organizational, communication, and interpersonal skills.
Nice-to-haves
- Experience in a community health or home health setting.
- Demonstrated decision-making skills and strong judgment.
- Bilingual in English and Spanish.
Benefits
- Competitive salary and performance recognition.
- Opportunities for professional development and career advancement.
