Clinical Program Manager

UnitedHealth Group-posted 9 months ago
$71,600 - $140,600/Yr
Full-time • Mid Level
Remote • Grand Junction, CO
Insurance Carriers and Related Activities
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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. Supports Clinical Quality Improvement objectives by facilitating and coaching designated clinical practices in the implementation of redesign and quality improvement strategies to improve patient, provider and health care team satisfaction, improved patient outcome, provider office efficiency, and management of total cost of care. Is responsible for the development and ongoing administration of clinical quality improvement programs. Provides program implementation support, measurement standards, and revisions that incorporate best practices with proven outcomes. Assists in assessment of progress and recommends strategies to achieve collaborative goals and facilitate sustainability. Uses project management skills and works collaboratively with the Manager and other intra and extra department managers to coordinate assigned projects and initiatives. Maintains active involvement with internal and external Clinical Quality Improvement activities by collaborating proactively with external stakeholders and internal departments as directed by the Clinical Quality Improvement Program Manager.

  • Works collaboratively with various internal and external entities and individuals in accordance with the Mission and Values of the company to assist in maintaining and enhancing RMHMO's reputation as the leader in managed health care.
  • Provides leadership by example to embed the organizational philosophy and culture.
  • Respect confidentiality and maintain confidence as described in the Confidentiality Security Agreement that is signed by all employees.
  • Providing delivery of the designated Clinical Quality Improvement program and/or projects to guide health care team redesign efforts toward population management, and training on quality improvement principles.
  • Create highly functioning practices and communities focused on maximizing the integration and effective utilization of developing HIT/HIE technologies at the point of primary care delivery to improve cost, quality and experience of care.
  • Routinely performs practice assessments, in collaboration with practices, comparing program or contractual requirements/deliverables with evidence of work provided by the practice for the purpose of identifying opportunities for improvement and/or program or contract compliance.
  • Provide practice support to facilitate the coordination, development, teaching, implementation, and evaluation of provider practices participating in Clinical Quality Improvement Programs.
  • Introduce and educate new provider practices to the program as directed.
  • Provide support to practice participants through email, phone, site visits, review and feedback on assessments and monthly status reports and other methods as identified.
  • Provides support to the clinical performance management team in their area of expertise (data, behavioral health, etc.) by collaborating with internal staff on the design and implementation of programs that build positive relationships between the health plan, providers, member and community stakeholders.
  • Identifies innovative ways to work with providers to meet the needs of our members and the health plan.
  • Participates in cross-functional workgroups as a ‘practice expert' to inform internal stakeholders of success, barriers and impact of initiatives on our members, the health plan and providers.
  • Uses a systematic approach and critical thinking skills to assist in guiding the team to create highly functioning practices and communities driven at the point of primary care delivery to improve cost, quality and experience of care.
  • Utilizes interpersonal and meeting facilitation skills to attend and participate in meetings as necessary and as directed by the manager.
  • Identifies innovative ways to engage and meet the needs of our members and providers.
  • Develop and maintain solid working relationships with provider practices, RMHP employees, and other community participants.
  • Utilizing established measurements to obtain baseline provider practice information and monitor ongoing progress towards achieving sustainability.
  • Facilitate the practice's use of available health information technology resource opportunities to improve overall practice efficiency and improved patient outcomes.
  • Utilize individual thought to develop, organize and evaluate data to resolve problems or determine course of action with the practice QI team.
  • Actively participate in scheduled Clinical Quality Improvement Department Team Meetings and other ongoing planning and development meetings.
  • Develop and maintain solid working relationships with state entities such as the Department for Healthcare Policy and Financing (HCPF).
  • Use excellent organizational skills, professional demeanor and tact to support various Clinical Quality Improvement activities.
  • Assist with event planning and logistics for provider education including location, speakers, content, registration, and other logistics as needed.
  • Provides support in area of expertise (data, behavior health, etc.) to the health plan to meet contract deliverables inclusive of all value-based contracts, as well as other external contract deliverables.
  • Works with minimal guidance and solves moderately complex problems; seeks guidance for only the most complex tasks.
  • Maintain the confidentiality of sensitive information obtained in the course of managing the project.
  • Bachelor's degree in health care management, nursing, behavioral health, related field or the combination of education and experience that would enable performance of the full scope of the position.
  • 5+ years post graduate progressive medical related experience.
  • 2+ years of experience in public health, quality improvement, and ambulatory settings.
  • General knowledge of business, health care and health care coverage issues.
  • Proven excellent written communications skills and presentation skills.
  • Proven ability to work collaboratively with diverse individuals and functions at all levels of the organization and external customers.
  • Resident of Colorado.
  • Experience with quality improvement processes.
  • Experience with Health Information Technology.
  • Clinical office experience.
  • Comprehensive benefits package.
  • Incentive and recognition programs.
  • Equity stock purchase.
  • 401k contribution.
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