Field Based Clinical Program Consultant - San Antonio, TX
Company: Optum
Location: Castroville
Posted on: September 29, 2024
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Job Description:
Optum -is a global organization that delivers care, aided by
technology to help millions of people live healthier lives. The
work you do with our team will directly improve health outcomes by
connecting people with the care, pharmacy benefits, data, and
resources they need to feel their best. Here, you will find a
culture guided by diversity and inclusion, talented peers,
comprehensive benefits, and career development opportunities. Come
make an impact on the communities we serve as you help us advance
health equity on a global scale. Join us to start -Caring.
Connecting. Growing together. -
The Clinical Programs Consultant is responsible for the management
and supervision of all Homecare Dimensions Clinical Programs. They
will implement and maintain performance improvement activities and
maintains regulatory standards for the clinical programs across the
branches. This Manager indirectly supervises all members of the
branch staff and performs all functions in professional and ethical
manner and collaborates with other members of the health care team
to ensure quality patient care. -
The Clinical Programs Consultant will assure consistent,
appropriate, and cost effective care by actively managing patient /
client needs, payer's expectations, company policy compliance, and
agency financial objectives. -They will maintain accountability for
achieving financial targets / profitability for the operation by
empowering and challenging people, recruiting and training the best
people, delivering quality in everything they do, providing the
right incentives, providing the resources people need, and creating
an environment that enables people to be successful.
This position requires Tuberculosis screening as well as proof of
immunity to Measles, Mumps, Rubella, Varicella, Tetanus,
Diphtheria, and Pertussis through lab confirmation of immunity,
documented evidence of vaccination, or a doctor's diagnosis of
disease.
This position is full time, Monday - Friday. Employees are required
to have flexibility to work any shift schedules during our normal
business hours -of 8:00 am - 5:00 pm OR 9:00 am - 6:00 pm. It may
be necessary, given the business need, to work occasional overtime.
-Our office is located at 19500 IH-10 W Bldg 2 San Antonio, TX -.
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We offer weeks of paid on-the-job training. The hours of the
training will be based on schedule or will be discussed on your
first day of employment. -
Primary Responsibilities:
Directs the daily operations of Clinical Programs to ensure the
provision of safe, quality, cost-effective care to patients that
contributes to the financial success of the branch.
Regularly evaluates the services and care provided by the branch to
ensure compliance with regulatory requirements, company policies
and procedures and sound business practices.
Directs the recruitment, hiring, and development of sufficient
clinical and non-clinical staff to ensure the delivery of safe and
consistent quality care to all patient/clients 24/ 7.
Assures that clinical caregivers have demonstrated the ability to
perform accurate and complete assessments, communicate with
physicians, plan for service delivery, plan for discharge, and make
excellent professional decisions. -
Directs or delegates the assignment of staff, monitoring of daily
and weekly schedules, and the matching of caregiver qualifications
to patient/client needs, Manage quality through patient/client care
appraisals and employee supervision.
Directs and participates in care coordination activities that
effectively coordinate communication regarding patient/client
problems, needs, psychosocial and spiritual concerns, and
implementation of an individualized, interrelated plan of care.
Manages documentation to ensure that the patient/client's clinical
record meets legal and regulatory requirements, facilitates care,
enhances the continuity of care, helps coordinate treatment and
evaluation of the patient/client, and establishes medical necessity
so payers will reimburse for the services that are provided.
Develops and maintains a working knowledge of all services and
resources available within the company and the community. -Directs
staff to meet patient/client needs through the identification and
use of all available resources.
Responsible for interfacing with intake to assure that
patient/client's are not admitted for clinical service (case
accepted) until they have received an assessment visit and a
determination has been made that they are appropriate for home
care.
Responsible for annual evaluations of staff according to company
policy and procedures and federal/state regulations.
Directs ongoing skill evaluations to assure that the staff's
abilities are consistent with the needs of individual
patient/clients and the marketplace.
Supervises clinical and operational processes by managing staff and
ensuring flow of information and documentation from inquiry through
discharge of all patient/clients.
Provides support and documentation needed to facilitate
reimbursement.
Assists with the development of an annual market assessment,
budget, and business plan and monitors expenditures and adherence
to company policies through the implementation of controls.
Assists the Vice President with assessing business opportunities
and provides information on costs that can be used in determining
the feasibility of pursuing local managed care opportunities. -When
directed, gathers information about marketplace pay and bill
rates.
Schedules staff meetings to communicate with employees, caregivers
when appropriate, regarding the needs and concerns of
patient/clients and their families, referral sources, clinical
updates, policy and procedure changes, and payer sources and the
potential for business that these customers represent.
Discusses operational issues to identify issues that may compromise
optimal service to customers.
Employs marketing and promotional efforts within the community to
support the achievement of new and existing programs.
Implements and maintains Quality Assurance Performance Improvement
for the branch by participating in Quality Assessment and
Improvement and CHAPs activities and assures participation of all
appropriate staff.
Provides information that enables the collection and root-cause
analysis of data to identify opportunities for improvement,
develops/oversees the development and implementation of action
plans that result in continuous quality improvement. -
Oversees branch operations and makes adjustments where needed to
increase the overall efficiency of the department.
Investigates complaints and incidents, -and oversees and
appropriate outcome/ resolution
Submits reports on or before deadline dates.
Provides back up support and handles other functional role
responsibilities, as required, to assure that operational needs are
met.
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:
Preferred Qualifications:
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. -
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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. -
#RPO #RED #RPOLinkedIn
Keywords: Optum, San Antonio , Field Based Clinical Program Consultant - San Antonio, TX, Professions , Castroville, Texas
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