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Sr. Clinical Transformation Consultant- Telecommute in NY, NJ, or PA job in Newark at UnitedHealth Group

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Sr. Clinical Transformation Consultant- Telecommute in NY, NJ, or PA at UnitedHealth Group

Sr. Clinical Transformation Consultant- Telecommute in NY, NJ, or PA

UnitedHealth Group Work from Home/Remote Full-Time

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

Positions in this function drive clinical relationships and engagement with physician practices, members, and pharmacies while partnering internally (with areas such as Network contract ACO mgrs, Health Care Economics and Analytics, Medical Directors, Reporting, Health Plan market leaders) with a goal of improving health, well-being, quality and practice performance while reducing medical costs. Positions are accountable for the full range of clinical practice performance which may include but is not limited to improvement on HEDIS and STARs gap closure, coding accuracy, facilitating effective education and reporting, effective super utilizer engagement (e.g., members with complex and/or chronic conditions), and proactively identifying performance improvement opportunities through the use of data analytics, technology, workflow changes and clinical support. These roles develop comprehensive, provider-specific plans to increase their physician practice performance, reduce readmissions and improve their outcomes.

If you are located in NY or NJ, you will have the flexibility to telecommute* 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 insure 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 work flows 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 learning's by way of team updates, written reports / articles, and / or presentations as called for by directors
  • Reviews the work of others
  • Develops innovative approaches
  • Sought out as expert
  • Serves as a leader/ mentor


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's degree or equivalent relevant experience 
  • 5+ 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
  • Experience leading groups and strong presentation skills
  • Excellent Microsoft Office Skills with Word, Excel, Outlook and PowerPoint
  • Access to high speed internet for home office set up
  • Lives in a NE State such as NJ, NY or PA
  • Willingness to travel up to 25% for face to face meetings throughout the assigned territory
  • 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)
  • 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 
  • Active, unrestricted RN license in the State of Residence
  • Physician practice experience
  • CRC or In the process of completing CRC; with 1+ years of coding experience
  • Demonstrated experience implementing Clinical Practice 
  • Experience preparing and presenting information to clinical and executive level leadershipTransformation initiatives designed to help provider or hospital groups achieve large-scale health transformation goals
  • Excellent relationship building skills with internal and practice teams to drive goal alignment

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)

*All Telecommuters 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.

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