Clinical Program Director - Laboratory and Pathology - Remote

UnitedHealth Group•Minnetonka, MN

3d•$134,600 - $230,800•Remote

About The Position

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 optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. The Clinical Program Director, Pathology & Laboratory provides strategic leadership for the development, implementation, and oversight of clinical programs designed to optimize laboratory and genomic testing utilization, affordability, quality, and outcomes. This role builds collaborative relationships with laboratories, specialty societies, provider organizations, and internal partners while working closely with Payment Integrity and network teams to address complex billing, coding, reimbursement, and claims issues. The Director leads cross-functional teams of program managers, analysts, technology partners, and business leaders through the full program lifecycle, from opportunity assessment and business-case development to implementation and performance measurement. Through solid clinical, financial, and operational expertise, this leader ensures programs align with evidence-based guidelines, organizational objectives, and financial goals while effectively managing multiple priorities and driving results across the enterprise. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

Undergraduate degree
5+ years of healthcare experience
4+ years in a leadership / management role
3+ years of laboratory/genomics experience
Demonstrated superior data analysis skills and experience with healthcare quality metrics
Demonstrated sound strategic, analytic and critical thinking skills with proven ability to use clinical, administrative and claims data to identify opportunities, inform program design and measure process, clinical and financial outcomes
Demonstrated solid history of quickly building relationships, gaining credibility and partnering with business leaders. Must excel at building teams and collaborating across multiple distinct business groups
Demonstrated ability to work with Agility team to design, build and implement IT support for clinical programs
Demonstrated ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizations
Demonstrated solid negotiation skills; the ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome
Demonstrated ability to manage others; ability to influence in executive settings
Demonstrated strategic thinking with proven ability to communicate a vision and drive results
Demonstrated creative problem-solving skills
Proven self-starter, initiates work independently

Nice To Haves

Master’s degree

Responsibilities

Clinical Program Implementation and Oversight
Utilization management, care management, value-based care programs and protocols to optimize total cost trend and utilization across clinical laboratory testing, including molecular diagnostics
Manage resources including flexible and agile pool of Program Managers, assign projects and efficiently move it through the project lifecycle from end-to-end
Oversee effective implementation of programs that have a variety of approaches and requirements in partnership with internal and external partners
Build and develop relationships across teams to ensure effective support and feedback loops and that deliverables are met
Ensure Program Managers complete implementation activities needed to efficiently move programs through the project lifecycle
Use problem solving skills and make decisions to move implementation forward
Expert in reviewing, evaluating and documenting business requirements and facilitating discussions with operational and technology partners, based upon business requirements for IT-related projects
Ensure compliance with financial goals
Partnership Skills
Develop and maintain solid relationships with executive leadership of internal teams and external vendors
Partner with executive leadership from all LOBs to achieve mutual success on achieving/exceeding targets
Develop and maintain solid relationships with provider groups/facilities for collaboration on clinical pilots and programs
Oversee frequent cadence of communications to allow deeper understanding of shared objectives, emerging issues internal and external
Payment Integrity Partnership
Lead efforts to understand and solve for the complexities of coding and reimbursing laboratory services
Ensure alignment with published guidelines and Society recommendations
Use problem solving skills and negotiation skills to resolve discrepancies
Represent UHC Value Creation Laboratory team in internal and external discussions
Quantitative Analysis
Develop cost benefit analyses and business cases for clinical programs
Develop and analyze Key Performance Indicators for clinical program for each line of business to define timelines and documentation necessary for financial compliance and performance
Interacting with HCE and LOB Finance teams to verify and report out on aggregate program performance
Solve complex financial performance barriers
Work with program managers and predictive analytics teams to accurately model performance expectations to set realistic financial goals
Provide guidance to program managers in evaluation of data from analytic teams to correlate the expected affordability to the operational reality of the program
Research Skills
Ability to search for, analyze and present innovative ideas regarding implementation of clinical laboratory programs in pipeline
Presentation Skills
Speak clearly on complex problems across a wide range of audiences
Provide regular updates regarding the implementation process and clinical programs for Joint Operating Committees, Team Leadership and Executive Sessions