Job title: Associate Director, Medicare Delegated Member Oversight and Clinical Program Operations
Company: UnitedHealth Group
Job description: 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.United Healthcare Medicare Clinical Programs is looking to hire an Associate Director, Medicare Delegated Member Oversight and Clinical Program Operations. This position will report to the Director, Medicare Delegated Member Oversight and Clinical Program Operations.
- Own the end-to-end management and oversight of the delegated member programs; identify and drive improvements and innovation
- Maintain positive, productive, open working relationships at all levels
- Analyze monthly performance and recommend new or enhanced clinical pathways based on trend
- Create tools with the ability to track/trend engagement and outcomes at the national and market level to bring awareness to negative trends and areas of opportunity
- Monitor for deficiencies resulting from poor clinical implementation or clinical operations support / misalignment to regulatory requirements and escalate as appropriate
- Prepares content for monthly clinical program meetings and Joint Operating Committee meetings (JOCs) with program leaders
- Develop internal relationships and lead cross-functional engagement (e.g. network, behavioral health, clinical, etc.) to support development of strategies
- Partner with CEOs, CMOs, and EDs in the markets to ensure that the clinical program meets the needs of the market and is demonstrating value
- Develop relationships with market clinical leaders and an understanding of the unique dynamics within markets
- Support the markets with continuous evaluation of the clinical program and vendor (if applicable) including driving evaluations and sharing of data on ROI and clinical outcomes with market leaders
- Serve as the accountable clinical leader and point of contact for any clinical program needs, issues and resolutions; escalating as needed
Primary Responsibilities:
- Manage the delegated member clinical programs
- Supporting the development or enhancements to deploy enhanced capabilities that achieve the highest quality outcomes
- Review performance of the delegated clinical programs to include quality outcomes, member experience and ROI and identify opportunities to improve and evolve the program
- Manage program portfolio at the national level with ability to drill into market specific performance to improve competitive position and drive optimal performance
- Ensure the market teams have the clinical tools and resources available to meet/exceed all goals
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:
- 3+ years of experience in Medicare
- 3+ years of experience designing and implementing clinical/quality programs in a Medicare health plan environment or equivalent experience
- 3+ years of experience working in a matrix organization
- Demonstrated skills in program design and execution
- Accurately scopes out projects, sets objectives and goals, develops schedules and resource assignments, measures performance against goals and evaluates results
- Solid demonstrated ability to lead business initiatives to a successful outcome
- Solid communicator; capable of effectively presenting ideas and selling concepts and tactics; excellent writer, proven ability to communicate effectively with executives; ability to quickly understand needs and act on those needs; ability to conceptualize and effectuate change management and “out-of-the-box” thinking
- Proven cross-functional influence and well-developed relationship building skills, willing to take a leadership role driving initiatives, working across organizations and structuring approaches to new opportunities
- Ability to effectively deal with ambiguity – can effectively cope with change, can shift gears comfortably, can decide and act without having the total picture, comfortably handles risk and uncertainty in a manner consistent with UnitedHealth Group’s core values
- Good negotiation, problem solving, planning and decision-making skills
Preferred Qualifications:
- RN, LCSW, or LPN/LVN license and 3+ years of experience in a related field preferred, including clinical or quality experience in a managed care setting; or any combination of education and experience, which would provide an equivalent background
- Good negotiation, problem solving, planning and decision-making skills
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.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.
Expected salary: $110200 – 188800 per year
Location: Minnetonka, MN
Job date: Thu, 26 Jun 2025 22:20:59 GMT
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