Health Underwriting Manager jobs in Moline, IL

Clinical Manager PACE

UnityPoint Health

Monday-Friday 8:00AM - 5:00PM

Full Time Benefits

Under the supervision of the PACE Executive Director, is responsible for managing the operations of the PACE medical clinic, and PACE Clinical staff in conformance with PACE regulations and policies, procedures and standards established by Siouxland PACE and UnityPoint Health. Works collaboratively with the PACE Program Manager, Business Manager, and Transportation/Facilities manager to manager day to day PACE operations, and Quality Performance/Performance Improvement .

Why UnityPoint Health?

• Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience  a culture  guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
• Benefits – Our competitive  Total Rewards  program offers benefits options like 401K match, paid time off and education assistance that align with your needs and priorities, no matter what life stage you’re in.
• Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
• Development – We believe equipping you with support and  development opportunities  is an essential part of delivering a remarkable employment experience.
• Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.

Hear more from our team members about why UnityPoint Health is a great place to work at  https://dayinthelife.unitypoint.org .

• Monitors operations and systems, identifies issues, problem-solves and works to improve departmental and agency-wide system issues in collaboration with other members of the interdisciplinary team.

• Provides for follow-up on clinic care and service delivery complaints and keeps all interested parties apprised of the situation. Documents complaints per QI policy.

• Collaborates with Medical Director/Physician, Nurse Practitioner and Quality Assurance/Program Improvement staff to develop Nursing Practice Standards and documentation.

• Monitors for consistent nursing home care practice at each participant home using established standards, policies and procedures. This includes but is not limited to caseload and chart reviews.

• Works in collaboration with the PACE Management Team to establish and maintain uniform, consistent care delivery for Siouxland PACE members, including collaborative problem solving on member appointments and transportation/home care needs.

• Ensures proper follow up on infection control and employee health protocols.

• Reviews all nursing feedback and incident reports.

• Oversees homecare needs of members in coordination with the Home Care Coordinator.

• Interfaces with members, families, contracted providers and the public in regard to issues related to the routine operation of the clinic and site.

• Reviews safety issues, including member falls and incidents as they occur, and reports to the interdisciplinary team, and appropriate committees.

• In collaboration with the Medical Director and PACE Program Manager, oversees the day to day clinical operations of the PACE program, Monitors standards and makes changes as needed.

• Assists PACE Operations Director with budget preparation and with monitoring and correcting the financial performance of site operations.

• Participates in assigned agency committees and in external associations as appropriate.

• Authorizes procurement and oversees maintenance of medical, pharmaceutical and oxygen supplies in the clinic; ensures that an appropriate inventory of these supplies is consistently maintained.

• Oversees encounter data collection for assigned areas.

• Participates as part of the PACE administrative on call rotation.
Basic UPH Performance Criteria

• Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.

• Demonstrates ability to meet business needs of department with regular, reliable attendance.

• Employee maintains current licenses and/or certifications required for the position.

• Practices and reflects knowledge of HIPAA, OSHA and other federal/state regulatory agencies guiding healthcare.

• Completes all annual education and competency requirements within the calendar year.

• Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.

Education

RN

Experience

One year of leadership in healthcare required

License(s)/Certification(s)

Valid driver’s license when driving any vehicle for work-related reasons.
Valid Auto Insurance
Applicable licensure must be maintained
Current CPR/BCLS certification
Maintain current Mandatory Reporter

Knowledge/Skills/Abilities

Employee performance management
Microsoft Office product knowledge.