Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
MISSION, VISION AND VALUES
“Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is to deliver the best healthcare experience by putting brilliant minds, empathetic hearts and personalized technology to work to create meaningful relationships between our members and Care Partners. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright People to embody and uphold our core values in work and interactions, both internal and external: Be Purposeful, Be Authentic, Be Brave, Be Positive, Be Respectful and Be Accountable.
SCOPE OF ROLE
The Manager Discharge Planning, Utilization Management leads a team of discharge planning nurses that are responsible for supporting Bright’s discharge planning function. The team is accountable for coordination of services for members admitted to and/or discharged from an inpatient acute or skilled facility. The Supervisor position will provide guidance, provide individual training and oversight to a group of discharge planning nurses as well as fielding inquiries directly. This individual will serve as a role model for team members, assuring both members and providers have a positive experience with the services they receive. This position is also responsible for ensuring the discharge planning team is working to achieve expected clinical outcomes. The Manager Discharge Planning, Utilization Management ensures all related initiatives meet all applicable state and/or federal regulatory requirements in addition to corresponding URAC standards.
- The Supervisor of Care Navigation job description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Provide leadership and direction to a team of Discharge Planning Nurses, inclusive of performance oversight, ensuring the team is working to achieve expected clinical outcomes.
- Support staffing and scheduling plans to meet departmental objectives as provided by leadership, including meeting specified service levels.
- Monitor operational key performance indicators to track service delivery against targets.
- Recruit, hire and train new team members.
- Enforce UM policies and procedures to ensure compliance with state and federal agencies as well as accreditation standards.
- Support the development and maintenance of standard operating procedures related to corresponding program functions.
- Participate in the development of operating models to execute utilization management solutions.
- Other duties and responsibilities as assigned.
This position has supervisory responsibilities for members of the Utilization Management team.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A minimum of an associate degree in Nursing desired.
- Three (3) or more years of supervisory experience within a consumer support function
- Two (2) or more years of healthcare related experience
- Awareness and experience with HIPAA requirements for healthcare communication
- Prior experience with URAC accreditation is desired, but not required
- Formal training in Six Sigma management techniques is desired, but not required
- Approaches challenges calmly and objectively to identify the best solution
- Capable communicator that can interact with others at multiple levels within the organization, customers and providers
- Leads through influence and example
- Strong operational mindset and uses data to draw insights
- Thrives on driving results in a collaborative environment
BEHAVIORAL AND LEADERSHIP NORMS
- Bright Values: Lives the Bright Values. Leads by example. Is viewed as an emerging leader in the company. Acts with quiet, calm determination. Effectively influences inside of the organization.
- Decision making: Drives strong decision making at a functional level. Is capable of taking a large sum of information, and drilling into what is important. Understands organizational impact of decisions and communicates effectively throughout the decision-making process. Pushes issues to resolution.
- Delivers Results: Is results oriented. Is capable of deciphering priorities for self and for others, and focuses the group on what must be done today, and who must do what. Is capable of clearly translating strategic objectives into implementable processes that drive outcomes. Focuses on results, not effort, and is able to efficiently direct time and energy to achieving intended outcome. Can successfully develop a budget and achieve it without sacrificing quality of output. Achieves strong results within their functional area. Has an excellent track record of achieving expected results. Understands how to operate in collaborative framework.
- Direct and Indirect Management: Demonstrates leadership skills. Has mastered autonomous work, and is able to successfully influence direct and indirect teams to achieve goals. Organizes people and resources toward the effective and pursuit of objectives: this includes hiring, firing, efficient supervising and performance appraisals. Delivers thoughtful and constructive feedback to teams, and actively works to develop those around them. Sets an example for our employees. Manages up appropriately and knows how and when to escalate an issue or situation to more senior manager.
- Planning and Execution: Identifies need for planning and has skills to develop, implement, monitor and achieve plans. Knows how and when to adjust plan. Leads others in this effort. Hold self and team accountable for effective planning and execution. Overcomes hurdles.
- Presence: Internally, leads large and small groups of people in meetings. Capable of developing thoughtful agenda, setting objectives, driving clarity of purpose and delivering the intended results. Instills confidence.
LICENSURES AND CERTIFICATIONS
- An active, Registered Nurse (RN) or Licensed Practical Nurse (LPN) license to practice as a health professional in a state or territory of the United States is required for this role.
The majority of work responsibilities are performed in a call center environment, carrying out responsibilities sitting/standing at a desk/table and working on the computer. Travel is not required.
EEO/AFFIRMATIVE ACTION STATEMENT
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. 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.
We’re Making Healthcare Right. Together.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.