Sr. Clinical Transformation Manager - Remote

UnitedHealth Group•Maryland Heights, MO

6d•$91,700 - $163,700•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 to start Caring. Connecting. Growing together The Senior Clinical Transformation Consultant (Senior CTC) is responsible for the ongoing clinical management of physician practices participating in UnitedHealthcare’s (UHC) Accountable Care Organizations (ACO), Value Based Programs, Patient Centered Medical Homes (PCMH), or Population Health Management programs such as Patient Centered Care Model. The Senior CTC will lead multi-disciplined practice transformation and practice performance improvement initiatives. The selected candidate will guide practices in achieving targeted goals that include improved quality, efficiency and utilization. The Senior CTC is accountable for driving practice progress toward desired transformational change and performance improvement, while meeting savings goals set for the practice. The Senior CTC reports directly to the Regional Director. The Senior CTC will act as a mentor to other Transformation Consultants on the team. As the single clinical point of contact for a practice, the Senior CTC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within UnitedHealthcare and at the practice. If you are located within a commutable distance of St. Louis and Springfield, MO area, you will have the flexibility to work remotely as you take on some tough challenges.

Requirements

Bachelor's degree or 9+ years of experience with improving clinical quality, health care analytics, or driving clinical transformation initiatives with population health programs, Patient Center MedicalHomes or in Accountable Care Organizations
5+ years of combined experience with improving clinical quality, health care analytics, or driving clinical transformation initiatives with population health programs, Patient Center MedicalHomes or in Accountable Care Organizations
2+ years of experience 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
Demonstrated experience leading groups and solid presentation skills
Solid Microsoft Office Skills with Word, Excel (Intermediate +), Outlook and PowerPoint
Demonstrated solid relationship building skills with internal and practice teams to drive goal alignment
Access to high speed internet for home office set up
Willingness to travel between 10-15%25 for face to face meetings
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)

Nice To Haves

Master's Degree
Active, unrestricted RN or LPN licensure in the State of Residence
Medicare Advantage experience
Medicaid experience
Commercial experience
Population health management experience within an ambulatory setting
Physician practice experience
Sales experience (Business to Business or Business to Consumer)
Demonstrated experience implementing Clinical Practice Transformation initiatives designed to help provider or hospital groups achieve large-scale health transformation goals
Experience preparing and presenting information to clinical and executive level leadership
Knowledge and/or experience with HEDIS measures
Knowledge and/or experience with risk adjustments
Knowledge and/or experience with STARS

Responsibilities

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