UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
You’ll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.
- Leveraging clinical operations knowledge and industry expertise, develops programs to improve health care quality and cost, including utilization management programs, value-based payment initiatives, and innovative member facing and / or digital technology-enabled programs focused on population health
- Works across the organization with other business partners in Network and Clinical Operations to partner with practices to develop and implement innovative solutions to develop and implement clinical programs
- Develop clinically sound policies, procedures, and guidelines for clinical programs and initiatives and ensure compliance with all applicable laws and regulations
- Provides leadership to and is accountable for the performance and results through multiple layers of management and senior level professional staff
- Responsible for development of business strategy, including business case to support investment in new initiatives, and manages business plans to achieve objectives
- Creates infrastructure and parameters for work stream, including specifying business requirement for technology partners when appropriate, and manages cross-functional work stream strategies and plans; directs cross functional and / or cross segment teams
- Translates highly complex concepts in ways that can be understood by a variety of audiences
- Fosters relationships with matrix partners / stakeholders
- Influences senior leadership to adopt new ideas, products, and / or approaches
- Leads large, complex programs to achieve key business objectives
- Communicates to internal and external audiences on UHC’s clinical program initiatives
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 in.
- Undergraduate degree or 11+ years of health care management experience with accountability for business results
- 7+ years of health care management experience with accountability for business results
- Experience in performing cost-benefit analysis and developing a business plan
- In-depth knowledge of health care industry
- Knowledge of coding and billing processes and provider reimbursement as these relate to clinical program design, development and evaluation
- Advanced with Microsoft Office applications (Outlook, Word, Excel, PowerPoint)
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
- Master’s Degree in a relevant field, including MPH, health services research, epidemiology, health economics, MBA
- Clinical degree including nursing or pharmacy and experience in developing oncology quality improvement or affordability programs for a practice, health care system or payer
- Managed care and / or health plan experience
- Public health or population health experience
- Experience in utilization management, case management, or other clinical programs for population health management
- Project management experience
- Quality Management experience
- Knowledge of the differences relevant to implementing programs across different lines of business and populations (i.e. Medicare, Medicaid, Commercial, Exchange)
- Solid negotiation skills; the ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome
- Demonstrated ability to manage others and processes through influence; ability to influence in executive settings
- Ability to optimize resources using strong interpersonal skills, excellent judgment, and an attitude that fosters teamwork and supports organizational goals
- Proven data evaluation and interpretation skills; ability to identify trend drivers, focus on key metrics
- Proven written and verbal communication skills that are clear, concise, detailed, professional, member and client facing
- Ability to form alliances with supporting organizations and work in a highly matrixed environment
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)
Colorado Residents Only: The salary range for Colorado residents is $130,300 to $250,200. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
Job Keywords: Clinical Program Designer, Oncology Value Creation, Program Management, Clinical Program Developer, Quality Director, Affordability Director, Value Based Contracting, MPH, RN, Pharmacist, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Minnetonka, MN, Minnesota