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Job Details


UnitedHealth Group

Director, Clinical Provider Solutions - Remote

Healthcare

Clinical

No

Brentwood, Tennessee, United States

naviHealth, part of Optum and the UnitedHealth Group family of businesses, combines the talents of our dedicated staff and leading-edge technology to deliver compassionate care to seniors nationwide. With millions of lives touched, we are innovating the way health care is delivered from hospital to home so seniors can lead more fulfilling lives. A career with us means making an impact in the lives of those we serve, including vulnerable populations who benefit from care that is more efficient, more effective and more human. Our environment empowers our team members to elevate our interactions with each other and the experiences we deliver to our patients, giving them more days at home. Join our team, it’s your chance to improve the lives of millions while doing your life’s best work.(sm)

The Director, Clinical Provider Solutions is responsible for leading a team that spans across markets, lines of business and clients. This position assists in developing and executing the strategy related to the naviHealth Developed of a Preferred Provider Network (PPN). This is a collaborative role requiring critical thinking skills, independence, leadership, a strategic mindset, and attention to detail.

Why naviHealth?

At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. naviHealth is looking to hire a Director, Clinical Provider Solutions with experience building mission-critical service-oriented applications. This role is a key-contributor to the organization and future technologies. Successful candidates will possess a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company’s technical vision and strategy.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Engage with Health Plan Partners on network formation strategy
  • Co- Lead Network formation sub-committee
  • Lead in market analysis of provider performance with nH Leadership team
  • Work closely with Data Management teams on provider performance tool enhancements to better serve the PAC environment
  • Engage with SNFs to market the nH PPN initiative
  • Support companywide initiatives, marketing the naviHealth brand and evolving Provider Operations
  • Work closely with Product Teams to ensure new developments align with clinical design expectations
  • Solid contributor to the development of Alternative Payment Models, providing clinical analysis and oversight
  • Remain current on all regulatory changes in the Acute and PAC environment
  • Functions as SME CMS Nursing Home Compare and other more broadly recognized provider performance measurement tools
  • Reads, interprets and educates on CMS policy and regulatory changes as it relates to provider clinical quality and performance measures
  • Lead in-market analysis of provider performance with nH Leadership team
  • Understand and influence the impact of regional/national providers in the market
  • Collaborate with clients to develop or narrow networks to high performing
  • Support training of nH Provider Relations Personnel on site visits and provider performance management
  • Own the development, enhancements, distribution and utilization of a proprietary Clinical Capability survey. Analyze and validate results using nH coordinate and site visits
  • Represent the Network/Provider Engagement Team in requests for strategic alliances with providers as well as trade agencies

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.

Required Qualifications:

  • Bachelor’s degree
  • Active, unrestricted registered clinical license – Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist
  • 10+ years of experience in a clinical/care delivery role
  • 5+ years in a management/leadership role
  • Experience in Acute and Post-Acute Care Continuum
  • Analytical skills and understanding of KPIs to improve business operations
  • Experience effectively negotiating and influencing
  • Proven presentation skills with high Emotional Intelligence
  • MS Office experience
  • Travel up to 25%
  • 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

Preferred Qualifications:

  • Master’s Degree
  • Experienced in managed care, health plan operations in provider contracting, customer service, or provider relations
  • Solid brand promotion experience

About naviHealth

Being a pioneer in post-acute management and care transitions with 19 years of experience, naviHealth is uniquely positioned to manage patients, improve clinical and financial outcomes, and share risk with payors and providers. We provide clinical service support alongside proprietary technology and advisory solutions that empower health systems, health plans and post-acute providers to navigate care episodes across the continuum, with the goal of reducing waste and improving patient outcomes.

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 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 your life's best work.(sm)

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado/Connecticut/Nevada residents is $113,500 to $218,100. 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.

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.

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