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UnitedHealth Group Director Case Management and Clinical Transformation - Telecommute in Eden Prairie, Minnesota

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The Director, Case Management is responsible to help drive care management partnerships for Optum clients or potential clients. This individual will work alongside client teams across the continuum of care to solve complex business and care management problems, improve performance, and execute highest priority initiatives. The ideal candidate for this role must be passionate about driving improvements in care delivery, effective at working in a fast-paced, high energy environment and confident in their interactions with senior leaders, providers, and business partners.

The role of the Hospital Performance Improvement team is to enable financial sustainability for hospitals and health systems by bringing innovative solutions to controlling and reducing operating costs. Successful hospitals are committed to continuously improving workforce efficiency, reducing supply costs, and addressing inefficiencies in care delivery. The Director, Care Management and Clinical Transformation will provide subject matter expertise that supports the assessment of health system care management capabilities and gaps, design of solutions that improve care delivery outcomes, foster best practice care management, and reduce unnecessary utilization that leads to measurable financial savings. As Optum expands its long-term transformational partnerships with health systems, the Director will lead due diligence initiative that identify long-term partnership solutions leveraging multiple Optum business units coming together to support full continuum care management, as well as lead the transition from due diligence to long-term partnership launch.

You’ll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

Primary Responsibilities:

  • Provide clinical subject matter expertise to initiative teams to drive financial and quality outcomes, focused primarily on long-term transformational partnership due diligence and implementation

  • Structure complex care management and care delivery challenges into frameworks that can be analyzed and solved, and coordinate integration of Optum solutions across the continuum of care into client partnerships

  • Leads and participates in due diligence activities to establish scope of Optum partnership with health systems to address continuum of care, as well as the transition of the Optum partnership, including rebadging client teams, implementing Optum solutions, and integrating with the client care management operations

  • Oversees the client delivery, solution design, and analytic requirements for delivery of high-quality Care Management consulting engagements or services, including presenting executive level reports and dashboards for demonstrating outcome trends

  • Assesses, designs, and implements strategic client goals related to Care Management programs targeted to promote the growth and enhancement of existing structures working in partnership with the organization’s executive and physician leadership

  • Provides subject matter expertise and/or oversight to engagements or other clinical consulting engagements depending upon additional clinical expertise

  • Oversees and manages OAS team members either directly or through a matrixed, client-based environment

  • Ensures that client expectations and contract deliverables are met during assigned engagement

  • Coordinates the development of short and long plans to drive effective clinical and non-clinical sourcing and utilization

  • Support the creation of sales pursuit materials and other business development activities (e.g. proposals and Statements of Work (SOWs))

  • Support ongoing design of best practice methodologies in ambulatory, acute, and post-acute care management, including developing job aids, training material, and instructions

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:

  • Bachelor of Nursing degree

  • 7+ years of professional experience in inpatient Care Management

  • Experience working in a highly matrixed organization

  • Proven experience developing and implementing operating plans, analyzing financial and quality data

  • Proven engagement experience with physicians, and ability to provide valuable insights and logical explanations when faced with difficult questions

  • Ability to implement centralized processes in a large complex environment

  • Ability to use Microsoft products, develop and deliver presentations

  • Success in yielding unprecedented results within the area of Care Management

  • Able and willingness to travel up to 50- 80% of the time

  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Masters/Graduate Degree, Healthcare Administration or Business Administration

  • Clinical consulting experience across multiple clinical and cost improvement-related areas, including care variation

  • Hospital or ambulatory care management experience

  • Experience in provider management and/or clinical transformation consulting engagements resulting in significant recurring financial benefit

  • Experience developing care continuum, cost reduction and clinical transformation methodologies and designing innovative solutions in a complex and rapidly changing environment

  • Foundational understanding of health systems/provider organizations

  • Preferred location: Colorado Springs, CO, Dallas, TX, Hartford, CT, Pittsburgh, PA, Boulder, CO, Houston, TX, Nashville, TN, Tampa, FL, Eden Prairie, MN, Phoenix, AZ, St. Louis, MO

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only : The Salary range for Colorado, Connecticut and Nevada residents is $113,500 to 218,100. 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.

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.