HSS Manager - Remote in Mesa County, CO

United Healthcare

Grand Junction, Colorado

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
Supports corporate objectives by utilizing specialized knowledge of Long Term Services and Supports to supervise HSS Coordinators providing Case Management services. Provides accountability and oversight for assigned staff. Participates in case conferences and assumes HSS Coordinator duties when necessary. Supports management of the LTSS Program as needed.
If you reside locally to Mesa County, CO, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:

Serve as a supervisor overseeing CMA Case Management functions and associated staff
Assumes HSS Coordinator duties when necessary
Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
Conducting supervisory case conferences with HSS Coordinators on a regular basis. Approval of indefinite lengths of stay, pursuant to 8.402.15
Regular, systematic review and remediation of case records and other case management documentation, on at least a sample basis
Communication with the Department when technical assistance is required by HSS Coordinators, and the supervisor is unable to provide answers after reviewing the regulations
Allocation and monitoring of staff to assure that all standards and time frames are met. Assumption of HSS Coordinator duties when necessary
Attending training and ensuring staff supervised also attends Department provided training for CMA agencies as well as agency provided in-service and staff development training. Supports management in ensuring the completion of all Work in accordance with the CMA Contract Agreement's requirements. This includes but is not limited to, ensuring the accuracy, timeliness, and completeness of all Work
Supports management in ensuring the timely submission and accuracy of all Deliverables submitted to the Department of Health Care Policy and Financing (HCPF) within prescribed time frames
Supports management in ensuring a response to all telephone calls, voicemails, and emails from the Department within two (2) Business Days of receipt by the Contractor, unless the situation is identified as urgent by the Department. For situations identified as urgent by the Department, supports management in ensuring a response to the Department the same business day but no later than twenty-four (24) hours following the request
Works with management to select, train, and appraise qualified staff
Assess workflow and distribute assignments to appropriate staff
Works with staff to evaluate and identify improvement opportunities and provides immediate and direct feedback
Communicates with management about training needs and performance of staff members
Works collaboratively with management to take corrective action as needed on a timely basis and in accordance with company policy
The Supervisor must demonstrate competency and ensure that HSS Coordinators supervised also demonstrate competency in the following areas:
Application of a person-centered approach to planning and practice
Ability to develop Support Plans and service agreements
Interviewing and assessment skills
Knowledge and experience working with populations served by the Case Management Agency
Knowledge of the statutes, regulations, policies and procedures regarding public assistance programs and the American with Disabilities Act
Knowledge of LTSS and other community resources
Negotiation, conflict resolution, intervention, cultural and linguistic training, disability cultural competency, and interpersonal communication skills; and
Knowledge of consumer direction philosophy and programs
Ensure HSS Coordinators supervised are able to perform intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the individuals health and welfare, documentation of contacts and case management activities in the Department prescribed IMS, resource development and case closure. Assume HSS Coordinator duties when necessary
Ensure HSS Coordinators are supervised and complete the required contacts with their members. Assume HSS Coordinator duties when necessary
Ensure HSS Coordinators are supervised and monitor the delivery of services and supports identified within the Support Plan and the Prior-Authorization Request (PAR). Assume HSS Coordinator duties when necessary. This includes monitoring:
The quality of services and supports provided
The health and safety of the individual; and
The utilization of services with respect to the Support Plan and the PAR
Ensure HSS Coordinators receive oversight reviews of their performance including their competency with completing the Level of Care Screen
The Supervisor will shadow case management staff completing the Level of Care Screen on an annual basis and prior to the end of each Contract Fiscal year to establish case manager's competency administering the Level of Care Screen
Documentation on case manager performance shall be maintained by RMHP and provided to the Department upon request
Supervisors, lead workers, or a case manager with at least three years of case management experience may perform the shadowing 13. In the event, at any time throughout the case management process, the supervisor suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency. Employees are obligated by statute, including but not limited to, Section 19-13-304, C.R.S., (Colorado Children's Code), Section 18-6.5-108, C.R.S., (Colorado Criminal Code - Duty To Report A Crime), and Section 26-3.1- 102, C.R.S., (Human Services Code - Protective Services), to report suspected abuse, mistreatment, neglect, or exploitation, are aware of the obligation and reporting procedures
May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed
This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage
Complete all duties in accordance with company safety policies and practices
Other functions may be assigned and management retains the right to add or change the duties at any time
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:
5+ years of relevant experience in the field of LTSS, which includes developmental disabilities, or the combination of education and experience that would enable performance of the full scope of the position
2+ years of demonstrated experience with LTSS programs
1+ years of competency in pertinent case management knowledge and skills
Driver's license and access to reliable transportation
Reside locally to Mesa County, CO
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $88,000 - $133,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

HSS Manager - Remote in Mesa County, CO

United Healthcare

Grand Junction, Colorado

Serve as a supervisor overseeing CMA Case Management functions and associated staff
Assumes HSS Coordinator duties when necessary
Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
Conducting supervisory case conferences with HSS Coordinators on a regular basis. Approval of indefinite lengths of stay, pursuant to 8.402.15
Regular, systematic review and remediation of case records and other case management documentation, on at least a sample basis
Communication with the Department when technical assistance is required by HSS Coordinators, and the supervisor is unable to provide answers after reviewing the regulations
Allocation and monitoring of staff to assure that all standards and time frames are met. Assumption of HSS Coordinator duties when necessary
Attending training and ensuring staff supervised also attends Department provided training for CMA agencies as well as agency provided in-service and staff development training. Supports management in ensuring the completion of all Work in accordance with the CMA Contract Agreement's requirements. This includes but is not limited to, ensuring the accuracy, timeliness, and completeness of all Work
Supports management in ensuring the timely submission and accuracy of all Deliverables submitted to the Department of Health Care Policy and Financing (HCPF) within prescribed time frames
Supports management in ensuring a response to all telephone calls, voicemails, and emails from the Department within two (2) Business Days of receipt by the Contractor, unless the situation is identified as urgent by the Department. For situations identified as urgent by the Department, supports management in ensuring a response to the Department the same business day but no later than twenty-four (24) hours following the request
Works with management to select, train, and appraise qualified staff
Assess workflow and distribute assignments to appropriate staff
Works with staff to evaluate and identify improvement opportunities and provides immediate and direct feedback
Communicates with management about training needs and performance of staff members
Works collaboratively with management to take corrective action as needed on a timely basis and in accordance with company policy
The Supervisor must demonstrate competency and ensure that HSS Coordinators supervised also demonstrate competency in the following areas:
Application of a person-centered approach to planning and practice
Ability to develop Support Plans and service agreements
Interviewing and assessment skills
Knowledge and experience working with populations served by the Case Management Agency
Knowledge of the statutes, regulations, policies and procedures regarding public assistance programs and the American with Disabilities Act
Knowledge of LTSS and other community resources
Negotiation, conflict resolution, intervention, cultural and linguistic training, disability cultural competency, and interpersonal communication skills; and
Knowledge of consumer direction philosophy and programs
Ensure HSS Coordinators supervised are able to perform intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the individuals health and welfare, documentation of contacts and case management activities in the Department prescribed IMS, resource development and case closure. Assume HSS Coordinator duties when necessary
Ensure HSS Coordinators are supervised and complete the required contacts with their members. Assume HSS Coordinator duties when necessary
Ensure HSS Coordinators are supervised and monitor the delivery of services and supports identified within the Support Plan and the Prior-Authorization Request (PAR). Assume HSS Coordinator duties when necessary. This includes monitoring:
The quality of services and supports provided
The health and safety of the individual; and
The utilization of services with respect to the Support Plan and the PAR
Ensure HSS Coordinators receive oversight reviews of their performance including their competency with completing the Level of Care Screen
The Supervisor will shadow case management staff completing the Level of Care Screen on an annual basis and prior to the end of each Contract Fiscal year to establish case manager's competency administering the Level of Care Screen
Documentation on case manager performance shall be maintained by RMHP and provided to the Department upon request
Supervisors, lead workers, or a case manager with at least three years of case management experience may perform the shadowing 13. In the event, at any time throughout the case management process, the supervisor suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency. Employees are obligated by statute, including but not limited to, Section 19-13-304, C.R.S., (Colorado Children's Code), Section 18-6.5-108, C.R.S., (Colorado Criminal Code - Duty To Report A Crime), and Section 26-3.1- 102, C.R.S., (Human Services Code - Protective Services), to report suspected abuse, mistreatment, neglect, or exploitation, are aware of the obligation and reporting procedures
May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed
This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage
Complete all duties in accordance with company safety policies and practices
Other functions may be assigned and management retains the right to add or change the duties at any time
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:
5+ years of relevant experience in the field of LTSS, which includes developmental disabilities, or the combination of education and experience that would enable performance of the full scope of the position
2+ years of demonstrated experience with LTSS programs
1+ years of competency in pertinent case management knowledge and skills
Driver's license and access to reliable transportation
Reside locally to Mesa County, CO
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $88,000 - $133,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.