Director of Medicare Delegated Member Oversight and Clinical Program Operations - Remote

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Director of Medicare Delegated Member Oversight and Clinical Program Operations is responsible for owning the oversight of core Medicare Delegated clinical programs, including Optum at Home and other delegated providers. This includes the ability to identify and drive improvements and innovation to drive differentiation and clinical program evolution. This Director will be accountable for coordinating and collaborating with delegated partners, M&R health plan leaders, CMOs, and the Network and Finance teams.

Reporting to the Sr. Director of Medicare Clinical Strategy, Program Development, and Operations, this individual will ensure ongoing communications and engagement of clinical stakeholders as well as standard processes for continuing to support markets past go-live to ensure contractual obligations and performance standards are met or exceeded.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Owns the delegated program relationships, serving as primary point of contact, and maintains positive, productive, open working relationships at all levels.
• Assess evidence base, competitive landscape, population framework, financial drivers, partner strategy and market trends to inform development and improvements to the model
• Brings forward recommendations and drives to resolution to gain cross-functional alignment and decision-making.
• Establish evaluation and ongoing monitoring strategies, and analyze relevant data sources to determine program effectiveness, identify improvement areas to enhance efficiencies, and implement process improvement activities
• Supports the program maturity lifecycle by ensuring smooth and timely program expansion, draw down, or transitions to other programs, keeping data driven approach to monitoring the implementation or draw down plan.
• Proactively develops various communication elements to socialize and align stakeholders regarding projects and statuses to facilitate decision making and understanding with the business and other partners, including develops executive level program summaries and communications.
• Participates and co-leads minimally quarterly performance review Joint Operating Committee meetings (JOCs) with program leaders, may be monthly with immature programs, providing oversight that JOCs are productive, driving agendas, ensuring follow-up items tracked and addressed to completion.
• Develop internal relationships and lead cross-functional engagement (e.g. network, behavioral health, clinical, etc) to support development of strategies
• Provide thought leadership and serve as SME for business and functional partners
  
  

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.

Required Qualifications

• 5+ years leading clinical program implementation or operationalizing clinical programs
• Experience driving quality results through setting clear goals, managing accountability and performance management for individuals and teams
• Proven prowess in leading complex implementations
• Proven conflict resolution and problem-solving skills
  
  

Preferred Qualifications

• Current clinical license such as Nurse, Physician, Pharmacist, Behavioral Health, or Clinical Social Worker
• Experience with Medicare
• Experience with clinical programs & systems
• Managed care experience that includes at least 1 of the following: quality improvement programs, care management, utilization management, provider enablement, ACO, or other relevant clinical programs
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
  
  

The salary range for this role is $124,500 to $239,400 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.