Remote Associate Director Clinical Medical Management RN

Optum

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Requisition Number: 2187451
Job Category: Medical & Clinical Operations
Primary Location: Eden Prairie, MN
(Remote considered)

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Clinical Performance Foundational Affordability is looking for an Associate Director of Clinical Medical Management to advance affordability, clinical outcomes and quality of integrated health care services.  The role is directly working with care delivery organization physician practices in integrating high risk care management and integrated health care strategies and solutions in care delivery practices and systems.  The Associate Director of Clinical Medical Management will be a member of the national Clinical Performance Affordability team and will be accountable to identify, assess, recommend and implement opportunities as a partner and/or subject matter expert.

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

Primary Responsibilities:

  • Use clinical, business and quality knowledge and expertise to effectively engage, influence and execute on evidence-based value models with physician practices, regional and national structures in Optum Care
  • Utilize a physician practice-based focus and facilitation lens/knowledge to effectively engage with and execute on national clinical performance initiatives
  • Provide education and execution subject matter expertise in complex clinical programming and execution (i.e., population health programs, chronic condition management, integrated care management)
  • Develop policies, procedures, and guidelines for medical and clinical operations programs
  • Lead and execute operational, clinical and business projects to increase value and efficiency
  • Evaluate regulatory changes and determine steps needed to implement in programs
  • Develop medical and clinical value based clinical and operational goals
  • Evaluate and improve management/service delivery systems utilized in member care
  • Interpret data/analytics and reports to develop and implement recommendations in clinical and medical value-based care modeling
  • Evaluate compliance with Federal, State, and Local regulatory and organizational guidelines
  • Evaluate programs and services against contractual requirements to bring together joint outcomes in integrated physical health/behavioral health performance
  • Ensure team members address gaps in performance against internal procedures and protocols
  • Apply metrics to evaluate services, employee performance, and program outcomes
  • Read and interpret reports (e.g., performance, service)
  • Identify causes of performance deficiencies and remediate with follow up actions
  • Drive implementation of best practices and standards
  • Develop operational budgeting for affordability initiatives in medical and clinical operations
  • Evaluate staffing ratios, risk stratification, etc. to effectively develop and evaluate staffing models
  • Read financial reports, identify reasons for financial performance gaps, and identify opportunities for improved financial performance and enhanced return on investment
  • Collect and review data to evaluate financial outcomes of programs and services
  • Conduct cost/benefit analysis on programs to drive efficiencies
  • Conduct competitive analysis and identify opportunities to enhance financial viability
  • Propose and obtain approval for capital expenditures for medical and clinical operations

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:

  • Current, active clinical license in state of residence: Registered Nurse or Licensed Clinical Social Worker
  • 7+ years of experience in management, leadership and facilitation of complex clinical programs
  • 5+ years of experience in team leadership, execution and development
  • Background/experience in physician practice quality programming and improvement
  • Fiscal capabilities to evaluate projects for value-based care & affordability outcomes
  • Ability to use computer with all office products
  • Ability to analyze large data sets and manage recommendations based on findings

 

Preferred Qualifications:

  • Master’s degree in healthcare related field or MBA
  • Background in complex care solutioning, either business or clinical
  • Proven excellent oral and written communication skills
  • Proven excellent presentation skills
  • Proven ability to work across multiple complex functions and teams end to end to execute on programs
  • Proven ability to work across the matrix and develop relationships to execute on solutions
  • Proven flexibility in day-to-day work responsibilities with start-up mentality and drive

 

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $101,200 to $184,000 per year. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.