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UnitedHealthcare, part of the UnitedHealth Group family of companies, is seeking a (Clinical Program Consultant), Manager of the Enhanced Care Coordination. This position is responsible for, but not limited to, managing the program, including process improvement, execution of clinical decision processes, perform planning activities based on health care assessment, implement interventions to achieve goals, evaluate effectiveness of interventions, demonstrate business and industry knowledge, and drive effective clinical decisions within a business environment.

The Clinical Program Consultant provides clinical leadership direction and support promoting the growth of the UHC Group Retiree business. Reporting to the business segment Chief Nursing Officer, this clinical leader partners with enterprise leaders to establish the clinical value proposition for external use and supports the member experience, growth, retention, and affordability for Group Medicare Advantage membership. This position also provides strategic direction and oversight of clinical programs, contracted vendors and enterprise clinical partners, ensuring customer and business requirements are being met.

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

Primary Responsibilities:

• Support Group Business Growth and Maintenance as Clinical SME:
• Provide Group constituents (e.g., sales, account management, and operations) with clinical support and problem resolution
• Support the clinical process exception process. Ensure that all non-standard requests follow the established enterprise processes for approval
• Maintaining and Updating the Clinical Value Story
• Clinical program engagement and partner/vendor collaboration:
• Work closely with Sales to be aware of the pipeline and potential growth areas to engage clinical partners (Optum, UCS, HouseCalls, others) early in the process
• Work with clinical business partners to achieve success in transitioning members from previous carriers to UnitedHealthcare Medicare & Retirement clinical programs and group-specific buy-ups
• Work collaboratively with business partners and URS leadership to ensure clinical partners implement new business successfully
• Promote a positive public image for URS and facilitate the establishment of effective and efficient external customer interface
• Work collaboratively with internal and external management in the coordination, implementation, and evaluation of clinical programs and processes being delivered to Group Retiree members
• Actively participates in preparing presenters for the annual, semi-annual and quarterly client performance management meetings for jumbo accounts
• Assists in the coordination of reports utilized during performance management meetings quarterly, semi-annually and annually
• Works with team members and business partners to develop, gain approval and implement innovative solutions to achieve positive results (Star ratings, risk adjustment, affordability, member growth and retention)
  

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 and unrestricted RN, NP or PA license
• 5+ years of clinical practice experience
• 2+ years of managed care/health plan experience
• Experience in population health management
• Proficient in Microsoft Word, Excel and PowerPoint
• Geriatric clinical experience or Medicare Advantage experience
• Ability to travel up to 25% - this is up to 25%, not consistently 25% 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:

• Master’s Degree
• Geriatric clinical experience
• Lives within PST or MST time zone
• Excellent presentation skills for both clinical and non-clinical audiences
  

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 UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

Colorado, Connecticut, Nevada, or New York City Residents Only: The salary range for Colorado residents is $97,300 to $176,900. The salary range for Connecticut/Nevada/New York City residents is $97,300 to $176,900. 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.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.