Sr Clinical Program Manager

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm)

The Business Development & Implementation Team (BD&I) supports United Clinical Services Medical Management (UCSMM) utilization management (UM) operations by providing consultation on new and existing business, program development and other requested business process involvement.

Candidate will serve as the primary relationship manager to ensure the successful implementation of customer specific requirements, including integration with both internal and external business partners.  Primary responsibilities include advising on UM process capabilities, issues resolution, ensuring contract compliance (operational and regulatory reporting, auditing, site visits, etc.) and oversight of UM program implementation, requiring coordination with multiple internal and external stakeholders.

Primary Responsibilities:

• Serve as internal/external contact for all customer specific issues related to UM program performance, providing ongoing education and training to support the business meeting customer requirements


• May perform/support annual customer specific audits


• Monitors performance through reporting


• Responsible for monitoring customer specific audits and reporting; working in collaboration with the business owners and legal/regulatory departments within assigned timeframes


• Provide input, structure and action plans for meeting customer requirements


• Strength in solving complex problems independently; proactively identifying new solutions to problems, as well as recognizing when to engaged others


• Assist in setting long term business strategies including the development and implementing of process initiatives or new product design offerings. Provides recommendations for implementation approaches


• Works closely internally and externally in order to ensure effective implementation of customer specific requirements; including meetings, communications, IS and Claims operations, clinical outreach programs, regulatory agency compliance, networks, contract compliance etc.


• Perform other related projects and responsibilities as assigned


• Travel as needed when required

Required Qualifications:

• Bachelor's degree preferred or equivalent account management experience.


• 1-2 years of consulting experience, managing business relations


• Experience in the development and implementation of medical cost affordability initiatives


• Demonstrated leadership skills and behaviors: Positive, professional, influential, and a team player


• Strong communication, presentation and analytical skills with an exceptional ability to prioritize required


• Strength in solving complex problems independently; proactively identifying new solutions to problems

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 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)

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.