Clinical Services Advisor - Telecommute

UnitedHealth Group Remote
clinical services advisor telecommute health compliance operations stakeholders leadership delivery operational engagements clinical operations management
  • 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 is improving the lives of millions.
  • Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably.
  • There is no room for error.
  • If you are looking for a better place to use your passion and your desire to drive change, this is the place to be.
  • It's an opportunity to do
  • your life's best work.
  • You'll enjoy the flexibility to telecommute
  • from anywhere within the U.S. as you take on some tough challenges.
  • Provides clinical LTSS leadership and strategic direction for client delivery teams, assist engagement leaders with complex and challenging tasks
  • + Ensures outstanding and consistent customer service - creates and maintains relationships across a broad set of stakeholders within the payer client organization, including key operational and strategic leaders
  • + Responsible for the integrity of operational processes, ensuring adequate human resources, and compliance with regulatory standards
  • + Responsible for supporting profitability targets for specific engagements, as well as pursuing and achieving performance-based targets in at-risk engagements
  • + Responsible for program governance processes
  • + Informs internal activities and product development activities, including identifying opportunities for service and solution enhancements
  • + Use industry knowledge of the client's local population health landscape and a cultural humility lens to inform development of the clinical operations strategy, working in partnership with clients to develop programs and services for the clients' market
  • + Provide thought leadership through ongoing & annual evaluation of the care management program to ensure efficacy on behalf of the client
  • + Serve as an external market liaison, driving strategic growth and collaborative relationships, including development of strong partnerships with community-based organizations, provider offices, hospitals, health systems, local health departments, and other partners as requested by the client
  • 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.
  • Relevant Advanced Degree (MBA/MPH/MHA, etc.)
  • with 8+ years industry experience OR Undergraduate Degree with 10+ years industry experience (health IT, provider operations, payer operations/management)
  • + 10+ years of experience developing growth strategies for organization(s), particularly around new business lines
  • + 10+ years of experience as a successful influencer who can interact effectively with diverse groups of stakeholders such as clinicians, healthcare administration, and staff
  • + NCQA & CMS Health Plan accreditation experience
  • + Ability to travel 20% within the United States
  • + 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
  • Experience leading EHR vendors' core capabilities, including knowledge of tools and systems
  • + Exceptional communication skills with both staff and clients
  • + Excellent presentation and negotiation skills with the ability to demonstrate these skills in both face-to-face and electronic formats including but not limited to telephone and email systems
  • + Excellent interpersonal skills, including the development, motivation and directing of teams
  • + Demonstrated success as a team player who can build collaborative relationships across an organization
  • + Engages in the development, implementation, and oversight of care coordination activities at the point of service through delegated entities and programs
  • + May manages team including clinical and operations staff
  • + Develops strategies with intersegment businesses for most efficient program execution
  • + Provides strategic planning, consultation, and technical assistance to ensure continuity of care for client members.
  • + Provides training and subject matter expertise to stakeholders on long term care programs and services.
  • + Initiates implementation of technologies to ensure service delivery and monitor compliance with contractual requirements related to community-based care (i.e., online portal access to view authorizations, installation of electronic visit verification systems and protocols, etc.
  • + Ability to work effectively within a matrix environment, influencing and leading others without a direct reporting relationship
  • + Ability to coach others to perform and achieve results
  • + Ability to solve problems by applying diverse skills and experience, demonstrate significant analytical capability, ability to manage through ambiguity and change while remaining self-motivated, organized, and resourceful
  • 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.
  • 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
  • The salary range for Colorado residents is $134,200 to $257,700.
  • The salary range for Connecticut / Nevada residents is $134,200 to $257,700.
  • Pay is based on several factors including but not limited to education, work experience, certifications, etc.
  • In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
  • No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
  • All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
  • UnitedHealth Group is a drug-free workplace.
  • Candidates are required to pass a drug test before beginning employment.

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