Market Nurse Leader RN Irving Dallas Fort Worth TX

UnitedHealth Group

Full Time
Irving, TX
Posted 3 weeks ago

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 best work.(sm)

WellMed provides concierge – level medical care and service for seniors,
delivered by physicians and clinic staff that understand and care about the
patient’s health. WellMed’s proactive approach focuses on prevention and the
complete coordination of care for patients. WellMed is now part of the Optum
division under the greater UnitedHealth Group umbrella.

The Market Nurse Leader is responsible for planning, organizing, and
directing clinic operations management in assigned market to meet clinical
operational needs, and ensure compliance with federal and state requirements,
Medicare guidelines, URAC/NCQA/AHCA/OSHA/Joint Commission standards;
responsible for developing and implementing policy and procedures, integrating
clinical practice guidelines into clinic processes, and overseeing nursing
practice standards of licensed nursing personnel. Impact of work is most often
at the local level and regional level. Focus is on broad
organizational/professional issues and strategic outlook. This position will
assist in the clinical professional development of the Clinic Operations
management team in their market. This position maintains continuous quality
improvement efforts and opportunities directed toward achievement of clinical
and healthcare outcomes. The success of this position requires the ability to
foster communication and teamwork between clinics/physicians, market
management team, corporate departments, and senior leadership. This position
will coach others in the application of clinical competency, translating
complex nuances related to clinical competency into easy to understand terms;
participates in senior-level discussions regarding clinical competency;
participates in the development of reference and resource materials on
clinical competency. Recognized as the SME for clinical competency, both
internally and externally. Develops and/or leads development of new
applications and approaches for activities related to clinical competency. The
Market Nurse Leader will assist senior leadership with long-term planning
initiatives assuring activities are appropriately integrated into strategic
direction and overall mission and values of the company.

Primary Responsibilities:

* Drives effective clinical decisions within a business environment

* Clinical Interface/Liaison (clinical problem solver with providers, interdepartmental teams; resolution of issues concerning members, program definition and clarification)
* Clinical Operations Analysis (monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits)
* Clinical Training (planning, coordinating, delivering and evaluating clinical training)
* Clinical Writing (writing nursing tools and reference information to support the design of clinical products and services)
* Demonstrates understanding of business implications of clinical decisions (e.g., financial ramifications)
* Asks critical questions to ensure member/customer centric approach to work
* Identifies and considers appropriate options to mitigate issues related to quality, patient safety or affordability when they are identified, and escalates to ensure optimal outcomes, as needed
* Utilizes evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results
* Identifies and implements innovative approaches to the practice of nursing, in order to achieve or enhance quality outcomes and financial performance

* Serves as subject matter expert to support compliance with applicable federal and state practice health and safety standards, with particular focus on clinical standards and occupational health requirements
* Conducts clinic assessments for compliance with state and federal health care requirements, Medicare guidelines, and URAC/NCQA/AHCA/OSHA/Joint Commission standards
* Oversees remediation and corrective action plans, resulting from internal assessments, audits, compliance reviews and self-identified issues
* Provides leadership and mentoring for clinic staff to ensure patient safety and quality care
* Serves as a clinical resource for QRA performance and PCMH implementation and sustainment
* Monitors and ensures compliance with Occupational Health Programs (e.g., TB Screening, Hep B Screening, N-95 Fit Testing, etc.)
* Advises executive leadership on clinic operations related to nursing practice standard of care
* Ensures clinic staff has demonstrated appropriate clinical competencies to perform clinic tasks
* Monitors patient satisfaction and implements plans and programs to continually enhance services provided
* Participates in professional development activities and education programs to keep staff abreast of health care trends and practices
* Performs all other related duties as assigned

Position is based out of the Irving Office and will require extensive
travel throughout the DFW market.

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

Required Qualifications:

* Master’s degree in Nursing or health related field (or Bachelor of Science in Nursing with additional 2 years experience in lieu of Master’s Degree)
* Active, unrestricted Registered Nurse (RN) Texas
* Eight or more years of related experience in a hospital or clinical setting, with three or more years at management level or higher
* Demonstrate proficiency in assessment, design, development, implementation, data collection/reporting, and evaluation of initiatives and/or programs
* Experience in providing leadership and direction for long-range strategic planning
* Able to establish cooperative and collaborative working relationships in the course of performing assigned duties
* Basic understanding of standards such as NCQA, AHCA, OSHA, Joint Commission, and Medicare in the managed care setting
* Proven ability to manage and direct various levels of employees
* Excellent verbal, written communication, presentation and facilitation skills
* 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

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

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.

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