Sr. Clinical Transformation Manager - Northern Indiana
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)
The Senior Clinical Transformation Manager (Sr. CTM) is responsible for the ongoing clinical management, alignment, and facilitation 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. The Sr. CTM will lead multi-disciplined practice transformation and practice performance improvement initiatives. The selected candidate will guide practices in achieving affordability goals that include improved quality, efficiency, and utilization. The Sr. CTM is accountable for facilitating practice progress toward desired transformational change and performance improvement, while helping the practice achieve savings and cost opportunity goals. The Sr. CTM will not be accountable for managing direct reports.
The Sr. Manager will serve as the main point of contact for all activities related to Value-Based activities to include but not limited to coordinating clinical and Joint Operating Committee meetings. This position will work closely with senior leadership, providing analysis and industry best practice. The position requires recurrent and meaningful interactions with senior business segment leaders, providing quarterly C-Suite Level presentations around progress towards goals.
The Sr. CTM reports directly to the Regional Director. The Sr. CTM will act as a mentor to other Transformation Managers on the team and will have responsibility to support at least two of our three lines of business, Medicare, Medicaid or Commercial.
If you are located in Northern Indiana, you will have the flexibility to telecommute* as you take on some tough challenges. No relocation assistance will be provided. Position will require up to 25% travel within the market.
- Accountable for 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
- Act independently with minimal supervisor oversight and conduct detailed analyses of affordability opportunities, and development of pertinent and insightful recommendations
- Accountable at a practice and market level, including but not limited to, educating practices on quality and utilization opportunities, program components and update
- 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
- Monitor and review the progress of the practice in milestone achievement and ensure the practice is accountable for successful completion
- Assist practices in creating work flows to optimize care delivery, introduce best practices improvements, and evaluate outcomes using rapid cycle improvements such as PDSA methods to reach mutual goals
- Build and effectively maintain productive 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, including UHC Market Leaders and leadership from our ACO partners
- Work with UHC market leads to support implementation of enterprise strategic initiatives that may fall outside of the planned VBC agreements as these special projects will focus on innovation within the health care delivery system
- Serves as the subject matter expert describing new programs or initiatives that drive transformative care delivery
- 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
- Exhibit a customer service mentality by aiming to deliver more than what is expected ahead of when it is expected
- Act as mentor to other Transformation Managers
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.
- 5+ combined experience with improving clinical quality, health care analytics, or driving clinical transformation initiatives with population health programs, Patient Center Medical Homes or in Accountable Care Organizations
- 3+ years demonstrated ability to drive relationships and clinical engagement with ACO or health system leadership and their key clinical influencers
- Experience preparing and presenting information to clinical and executive level leadership
- Proficient Microsoft Office Skills with Word, Excel, Outlook, PowerPoint, and One Note
- Access to high-speed internet for home office set up
- Access to reliable transportation that will enable you to travel to client sites within a designated area (markets may require valid driver’s license)
- Willingness to travel up to 25% for face-to-face meetings, based on market specific needs
- 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
- Master's Degree
- Coding degree, CPCCRC or RHIA/RHIT license
- Active, unrestricted LPN or RN license in the State of Residence
- 4+ years of working with providers on HEDIS and STAR measures, clinical quality measures, CAHPS/HOS, or other value-based quality measures
- 2+ years of experience interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change
- Demonstrated experience implementing Clinical Practice Transformation initiatives designed to help provider or hospital groups achieve large-scale health transformation goals
- Physician practice experience
- Medicare, Commercial, and/or Medicaid experience
- Experience using PDSA cycle improvement approach
- Ability to work in an ambiguous environment
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. 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. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
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)
*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.