UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
This position is part of the Value Creation – Radiology Team. Value Creation Teams are responsible for comprehensive affordability strategy development, direction, and execution within a category (e.g. Radiology, Oncology, Genetic Testing, Musculoskeletal, Emergency Department, and Cardiology). Teams focus on cost, utilization management, quality improvement, revenue maximization, regulatory and contractual compliance and improved provider and member experience. The Clinical Program Manager supports the Value Creation Radiology Category team in vendor relationship oversight and ongoing management of program operations, and engages internal and external organizational partners to execute on comprehensive Value Creation strategy for Radiology and Cardiology initiatives.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Support Radiology Team lead in oversight and ongoing management of operations for large, complex programs to achieve key business objectives with focus on Radiology, Cardiology, Oncology and Site of Service
- Participates in the development of business strategy and manages business plans to achieve objectives
- Manage day-to-day relationships with program teams to drive performance excellence, promote best practices and seek solution-oriented initiatives
- Research and resolve provider/member/network inquiries specific to Value Creation programs; collaborate with external vendors, IT, claims, operations, provider relations and clinical services to resolve issues and implement solutions
- Ensure program compliance with state and federal regulatory requirements; collaborate with regulatory and compliance teams to develop and implement new regulatory and compliance requirements
- Support multidisciplinary teams in business requirement assessments for new/existing programs, advance enhancements to drive efficiencies, address system deficiencies and/or facilitate corrective actions
- Coordinate, facilitate, and actively participate in operational meetings with internal and external stakeholders; ensure customers, vendors and senior management are provided relevant and timely information on program status, risks, and mitigation strategies
- Collaborate with internal subject matter experts to research ad hoc system and technology-related program issues; identify root cause and implement proactive solutions; Monitor implementation plan against milestones and/or IT release dates to ensure successful delivery of solution
- Actively participate in multidisciplinary teams to achieve program deliverables; Foster and promote collaborative relationships with matrix partners/stakeholders; Establish trust and credibility at all levels of the organization; Work independently and as a team member
- Solve unique and complex problems with broad impact on the business; translates highly complex concepts in ways that can be understood by a variety of audiences
- Create & participate in senior management presentations, as requested
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.
- Undergraduate degree or equivalent work experience
- 5+ years of healthcare industry experience
- 3+ years project management or project work related experience
- Knowledge of CPT, HCPCS, and correct coding guidelines
- Demonstrated ability to manage others and processes through influence
- Ability to form alliances with supporting organizations and work in a matrixed environment
- Solid data analysis and interpretation skills; ability to focus on key metrics
- Excellent communication skills, including ability to communicate effectively with various levels of leadership, including ability to convey complex or technical information in a manner other can understand
- Proficiency with MS Office, (Excel, Word, PowerPoint and SharePoint)
- Post-graduate degree
- Critical thinking and creative problem-solving skills; demonstrated ability to work independently and systematically analyze complex issues, draw relevant conclusions and implement effective solutions
- Exceptional verbal and written communication skills; strong presentation and organization skills
- Adaptable and flexible; established ability to manage multiple initiatives and work effectively and thrive in a fast-paced, changing environment and contribute innovative ideas to achieve positive results
- Strong team player/interpersonal skills - ability to influence and work with people of different backgrounds; proven ability to form alliances with supporting organizations
- Approaches work with a high sense of accountability and attention to detail - takes ownership of tasks, performance standard and quality results
- Accuracy and Efficiency - excellent time management and organizational skills, balancing multiple priorities; maintain accuracy when processing detailed tasks while meeting deadlines
- Self-starter, initiates work independently; able to drive and prioritize work with minimal oversight
- Demonstrated ability to optimize resources using strong interpersonal skills, excellent judgment, and an attitude that fosters teamwork & supports organizational goals
- Claims systems and/or reimbursement methodology experience
- Knowledge of Medicare and Medicaid regulations and operations
- Basic familiarity with UHC applications and platforms (i.e., USP, Salesforce/ACET, ICUE)
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where-ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none. This is no small opportunity. It's where you can do your life's best work.(sm)
Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*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.
Job Keywords: Program Manager, Project Manager, Project Management, Program Management, Affordability, Cost Containment, Cost Management, Provider Satisfaction, Remote, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home