Requisition number: 2360042
Job category: Medical & Clinical Operations
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 Clinical Transformation Manager (CTM) is responsible for the ongoing clinical management of physician practices participating in UnitedHealthcare's (UHC) Accountable Care Organizations (ACO), Value Based Programs, Patient Centered Medical Homes (PCMH), or Population Health Management programs such as Patient Centered Care Model. The CTM will lead multi-disciplined practice transformation and practice performance improvement initiatives. The selected candidate will guide practices in achieving targeted goals that include improved quality, efficiency, and utilization. The CTM is accountable for driving practice progress toward desired transformational change and performance improvement, while meeting savings goals set for the practice.
As the single point of clinical contact for a practice, the CTM will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within UnitedHealthcare and at the practice.
If you are located within the Northeastern region of the U.S, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Accountable for successful deployment of UHC's Clinical Support program at the practice level, including but not limited to, introducing, and educating practices on the value/use of reporting tools, patient registries, and delivery of reports via UHC's Physician Portal
Build and effectively maintain relationship with the practice leadership and key clinical influencers actively involved in practice transformation
Regularly facilitate efficient, effective practice improvement meetings with the practice to monitor, present, and discuss progress on the transformation action plan and achievement in milestones
Develop strategies; based on performance analysis, for improvement that includes specific outcomes and metrics to monitor progress to a goal and make recommendations for improvement
Design practice transformation action plans and implement appropriate performance improvement initiatives designed to assist the practice in achieving contractually required transformation milestones
Monitor and review the progress of the practice in milestone achievement and ensure the practice is accountable for successful completion
Use data to analyze key cost, utilization and quality data and interpret results to assess the performance of the practice
Use data to analyze trends and work with stakeholders to agree on and implement proactive strategies to address issues, and measure impact using a PDSA rapid cycle improvement approach, including external practice data
Assist practices in creating workflows to optimize care delivery, introduce best practices improvements, and evaluate outcomes using rapid cycle improvements PDSA methods to reach mutual goals
Educate & Deploy technology tools to support Practice Transformation
Integrate technology tools into practice workflows
Build and effectively maintain relationships with team members in the UHC Clinical organization as well Medical Directors, local Network leads, Health Care Economic Analysts and Clinical Analysts in support of the program
Consult and partners with internal UHC matrix partners and the practice to identify organizational and structural challenges hindering achievement of desired program outcomes
Collaborate with UnitedHealthcare teams including the practice Care Coordinators, quality management teams, hospital clinical teams, behavioral health teams to support integrated PCP driven care for our members with practices and hospitals
Consult and guide the practice on developing innovative solutions, including bringing best practice experience and connecting practices with other high performing practices to spur innovation
Work with the practice and Optum to align and integrate Optum care/disease management programs and population health services to augment the practice's capabilities, support their care management efforts and add value to the patient care experience
Assist and support department leaders in summarizing and disseminating experience - related learnings by way of team updates, written reports / articles, and / or presentations as called for by directors
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:
4+ years of combined experience with improving clinical quality, health care analytics, or driving clinical transformation initiatives with population health programs, Patient Center Medical Homes or in Accountable Care Organizations
Experience in interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change
Experience working with and collaborating successfully with senior level leadership
Demonstrated experience leading groups and solid presentation skills
Solid Microsoft Office Skills with Word, Excel, Outlook, and PowerPoint
Proven solid relationship building skills with internal and practice teams to drive goal alignment
Access to high-speed internet for home office set up
Willingness to travel between 25-75% for face-to-face meetings (varies by market)
Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area (markets may require valid driver's license)
Preferred Qualifications:
Demonstrated experience implementing Clinical Practice Transformation initiatives designed to help provider or hospital groups achieve large-scale health transformation goals
Experience preparing and presenting information to clinical and executive level leadership
Physician practice experience
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay 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 $72,800 to $130,000 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.
