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Member Transition Manager - Job Opportunity at UnitedHealthcare

Boise, USA
Full-time
Senior
Posted: February 7, 2025
Remote
USD 89,800 - 176,700 per year

Benefits

Comprehensive 401(k) matching program with strong employer contribution
Healthcare benefits (implied as healthcare company)
Competitive incentive and recognition programs
Equity stock purchase options
Remote work flexibility

Key Responsibilities

Strategic oversight of care transitions across Idaho's Medicaid and Medicare programs
Development and execution of operational solutions for complex healthcare transitions
Performance metrics management and regulatory compliance oversight
Cross-functional collaboration for systemic healthcare delivery improvement
Strategic partnership development with healthcare providers
Quality assurance and audit management

Requirements

Education

Masters level clinical degree (implied by LCSW/LMSW requirement)

Experience

2+ years Medicaid healthcare experience, 2+ years Case Management, 2+ years program leadership

Required Skills

Microsoft Office proficiency Organizational skills Team building Leadership Problem-solving Communication with complex needs patients Performance metrics management Regulatory compliance expertise

Certifications

Current Idaho LCSW, LMSW, LMHP or RN license CCM (preferred)
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Sauge AI Market Intelligence

Industry Trends

Healthcare delivery models are rapidly shifting toward value-based care with increased focus on care transitions Growing emphasis on integrated care management across different healthcare settings Rising demand for remote healthcare management solutions due to technological advancement and post-pandemic adaptation Increasing focus on social determinants of health in care transition planning

Salary Evaluation

The offered range is competitive for the region and role, particularly at the upper end which reflects the complexity and scope. The wide range (89.8k-176.7k) suggests significant room for negotiation based on experience and certifications.

Role Significance

Likely managing a team of 5-10 care coordinators while collaborating with multiple cross-functional teams
Senior management position with strategic influence on healthcare delivery outcomes and operational efficiency

Key Projects

Care transition program development and optimization Quality metrics improvement initiatives Provider network collaboration strategies Regulatory compliance programs Care coordination system implementation

Success Factors

Strong understanding of both clinical and operational aspects of healthcare delivery Ability to navigate complex stakeholder relationships Excellence in change management and process optimization Deep knowledge of healthcare regulations and quality standards Strong data analysis and performance measurement capabilities

Market Demand

High demand position reflecting healthcare industry's focus on care coordination and cost management. Transition management roles are becoming increasingly critical as healthcare systems aim to reduce readmission rates and optimize care pathways.

Important Skills

Critical Skills

Healthcare regulations and compliance knowledge Care coordination expertise Leadership and team management Performance metrics analysis Stakeholder management

Beneficial Skills

Change management expertise Population health management Healthcare technology systems knowledge Quality improvement methodologies Risk management

Unique Aspects

Rare combination of clinical expertise and management requirements
Significant salary range indicating high value placed on experience and performance
Remote work opportunity in healthcare management sector
Direct impact on community health outcomes

Career Growth

2-4 years in role before advancement, depending on performance and organizational growth

Potential Next Roles

Director of Care Management Regional Healthcare Operations Director Population Health Executive Clinical Program Director

Company Overview

UnitedHealthcare

UnitedHealthcare is one of the largest healthcare companies globally, focusing on healthcare coverage and benefits services

Industry leader in healthcare insurance and managed care services with significant market influence
Strong presence in Idaho healthcare market with established provider networks
Corporate environment with emphasis on performance metrics and regulatory compliance, balanced with focus on healthcare innovation
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