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Consultant for Clinical Performance Optum Telecommute in Southern CA at UnitedHealth Group

Consultant for Clinical Performance Optum Telecommute in Southern CA

UnitedHealth Group Work From Home, GA Full-Time

***20K Sign on Bonus for external candidates***

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 Senior Director of Managed Care, Affordability is accountable for supporting the Pacific West, including the Optum California, Washington, and Oregon markets, in explaining clinical outcomes, inpatient utilization, and medical expense. This includes leading an operational team in shaping and executing medical management and network strategy initiatives to support affordable care.  This leader will oversee a range of central operations and analytical teams in a dyad partnership supporting clinical services focused on medical expense drivers, inpatient performance, population health, and UM analytics.  It requires an analytical and operationally focused executive experienced at providing consultative guidance, translating quantitative insights into operational change in a matrixed reporting environment.

If you are located in Southern CA, you will have the flexibility to telecommute* as you take on some tough challenges. 

Primary Responsibilities:

  • Responsible for developing and driving Population Health strategy and operations across Pacific West. This includes setting annual strategy on controlling cost of care and the identification of impact levers across all Pacific West regions. 
  • Operates in a consultant role in clinical dyads across the organization to support the operational execution of clinical outcomes and cost of care goals. 
  • Own accountability for the following topics for Optum's California and Pacific Northwest markets (currently 3M+ patient lives and growing):
    • Medical expense programmatics and analytics to support strategic contracting and development of evidence-based medicine strategies
    • Inpatient analytics to identify utilization opportunities and facility-based efficiencies
    • Focused Utilization management analytics, including leakage review/action planning and network management processes
  • Partners with several internal and external stakeholders such as regional clinical leaders to develop and manage annual scorecards of $80M+ in prioritized medical management and network strategy initiatives across six core themes:
    • Reducing inappropriate facility utilization
    • Effective use of wraparound services (e.g., disease management programs)
    • Optimal Care (evidence-based medicine)
    • Strategic network management (contracting and network structure opportunities)
    • Pharmacy Part B strategies
  • Drive integration of healthcare economics reporting, tools, and field partner support across 8+ legacy care delivery organization
  • Lead a team of 5-10 Senior Manager and Director-level reports, with their own respective teams focused on these topics
  • Build strong relationships within the organization including significant exposure to market level and national Chief Medical Officers and Chief Financial Officers
  • Other duties as assigned

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 at minimum from a four-year accredited school 
  • 7+ years of work experience with depth in analytics, change management and strategic planning
  • 2+ years of management experience with large groups (5 or more employees)
  • Advanced understanding of value-based healthcare 
  • Proficient in Microsoft Office applications

Preferred Qualification:

  • Post-graduate degree (MBA, MHA, JD, etc.)
  • 5+ years at a top 10 strategy consulting firm
  • Managed care experience 
  • 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. 

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.

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.

Recommended Skills

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