TRICARE Service Center Manager - McChord AFB, Tacoma, WA at Tacoma

Job Description

UnitedHealthcare Military & Veterans are currently looking for a Service Center Manager. Primary responsibilities are performed in a TRICARE Service Center (TSC) located in a Military Treatment Facility (MTF), most often on a military installation. Manages the activities of the TSC to ensure compliance with contractual requirements and maintenance of customer service standards. Serves as the primary liaison between the MTF regarding TSC operations, network adequacy/availability, and referral/authorization issues. Clinical advisor to the Director of Market Operations (DMO), assisting in building and maintaining relationships between MTF staff and civilian providers and facilities; supports MTF Optimization initiatives.** This position is located at McChord Air Force Base in Tacoma Washington. Candidate must have Washington license and work at this Military Treatment Facility***Primary Responsibilities:Conducts ongoing TSC staff development activities, including routine performance feedback and counseling.Acts as clinical resource for Director of Market Operations, Healthcare Coordinator, and/or non-clinical TSC staff regarding beneficiary care issues.Provides operational and clinical support to other TSCs within the Operations Area, as warranted. Ensures implementation and compliance with UnitedHealthcare Military & Veterans (UMV) policies, procedures and performance standards. Maintains close communications with the DMO regarding TSC operations, communications, MTF issues, local network, and Hub.Actively participates in meetings and communications with MTF staff.Assists the Director of Market Operations in planning meetings and participates in those meetings.Delivers a variety of prepared presentations about the TRICARE program to small and large groups.Facilitates special coordination of beneficiary care issues between the MTF, UMV Corporate resources.Participates in meetings, studies, and training as directed by the Director of Market Operations or the Office of the Vice President Operations.Maintains ongoing communications with the MTF Referral Management Center and/or MTF TRICARE Operations staff to resolve identified referral and authorization issues. Identifies and reports potential risk management and quality of care issues to the Director of Market Operations, Regional CEO and/or medical management staff as indicated.Provides information to the MTF on the availability of local area healthcare resources and programs.Participates in performance improvement activities.Participates as a team member with Health Care Services regarding Referral Processing, Utilization Management (UM), Case Management (CM), and Integrated Behavioral Health (IBH) initiatives.Collaborates with the MTF staff to identify and refer patients for potential CM, DM or other services, as indicated.Performs other duties as assignedRegular and reliable attendance is requiredResponsibilities will include acting on behalf of the Director of Market Operations as needed

Job Requirements

Bachelors of Science Degree in Nursing. 3+ years of documented supervisory experience.Excellent verbal and written communication skills Current and unrestricted Nursing license in the State Of Washington United States CitizenshipAbility to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86.Assets:Thorough knowledge of TRICARE and MHS is strongly desired5+ years of clinical nursing experience is preferred As a requirement of UnitedHealth Groups contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 www.opm.gov/forms/pdf_fill/sf86.pdf, (the National Agency Check or "NAC"). Successful completion of the NAC process is a requirement for continued employment in this role. NAC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NAC approval will result in termination from this role. Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. Thats why UnitedHealthcare is the organization thats called on to serve them and their loved ones. Were all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. Its a genuine opportunity to do your lifes best work. Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.Key words: McChord Air Force Base, Manager, Customer Service, Supervisor, Tacoma, Washington, Tricare, BSN,military, military treatment facility, referrals
Country: USA, State: Washington, City: Tacoma, Company: UnitedHealth Group.