UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.

Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.

Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?

Job Description

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health. OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
 
Optum delivers personal health management solutions designed to help individuals stay healthy, get healthy and live with illness. Evidence-based medicine, technology and specially trained nurses are combined to identify an individual's health needs, make referrals to appropriate resources and close gaps in care. With capabilities ranging from wellness promotion to self-care and triage to longitudinal case management, Optum delivers an integrated, cohesive approach to managing the health of each individual--as an individual.
 
If you're seeking a rare combination of support and resources for your career, Optum is the healthy business for your professional success.
 
A mid-level position within Optum that serves to bridge the gap between products, sales and operations. Utilizing existing resources in operations and products this position will be responsible for:

• Monitoring on a client by client basis, trend and performance against book of business targets for key indicators and developing corrective action plans when required.  Collaborating with account management, site operations leadership and program partners to execute on action plans and monitor monthly.
• Performing annual clinical analytical review on top accounts and others as requested and a) communicate variances to, or achievement of, committed metrics consistent with OptumHealth product definitions and/or performance guarantees and b) identify clinical product opportunities and make recommendations with defined value to support client population needs.
• Developing solutions based on clients business requirements and/or internal operational process gaps.  Position would have responsibility for working independently on less complex clients and those not requiring sophisticated integrations or new processes, for complex clients would be able to solution with Director oversight. 
• Acting as a clinical subject matter expert to products and operational staff for innovative customer program design and development.
• Providing oversight of simple customer implementations.  For those that involve multifaceted clinical products and deliverables works with Director oversight.
• Communicate client specific factors that may affect performance to account management, site operations and program partners.  These include, but are not limited to;
  •   Client Value Drivers
  •   Outside Vendor issues
  •   Network / Clinical Gaps
  •   Cultural Overviews
• Review as is processes to identify barriers which may contribute to underperformance specified accounts. Propose alternatives in collaboration with site operations and program partners that are cost / benefit neutral.
• Act as a liaison / informational resource for external program vendors, internal partners, and peers.  Also, as needed serve in a client facing role to represent Optum Health products and services.
• Other duties as assigned.

 
At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.


Job Requirements

• RN or masters level education required or 10 years in a manage care environment working in a clinical staff role will be considered in lieu of RN
• 5 + years working in a clinical operational environment (ie, Pharma, Employer, Provider, MCO)
• 5 + years resolving complex internal/external customer issues and identifying and implementing process improvements
• 3+ years of external client facing or customer facing experience required
• 3+ years proven analytics background (gathering data reports, analysis of data, identification of changes, creation of action steps based upon findings)
• 25% to 50% travel required
• Basic level Microsoft Office skills is required
• Preferred but not required:
• Previous experience in utilization management, case management, disease management or discharge planning
• Previous experience with clinical product operations such as, but not limited to: Nurseline, complex condition management, case and/or disease management
• Knowledge of clinical program design, implementation, management/monitoring to support choice in consumer care. Understanding of the medical utilization implications of such programs
• Previous management or operational experience related to cross-carrier operations

 
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
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.