The Clinical Program Director, Pathology & Laboratory provides strategic leadership for the development, implementation, and oversight of clinical programs designed to optimize laboratory and genomic testing utilization, affordability, quality, and outcomes. This role builds collaborative relationships with laboratories, specialty societies, provider organizations, and internal partners while working closely with Payment Integrity and network teams to address complex billing, coding, reimbursement, and claims issues.
The Director leads cross-functional teams of program managers, analysts, technology partners, and business leaders through the full program lifecycle, from opportunity assessment and business-case development to implementation and performance measurement. Through solid clinical, financial, and operational expertise, this leader ensures programs align with evidence-based guidelines, organizational objectives, and financial goals while effectively managing multiple priorities and driving results across the enterprise.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:Clinical Program Implementation and Oversight
- Utilization management, care management, value-based care programs and protocols to optimize total cost trend and utilization across clinical laboratory testing, including molecular diagnostics
- Manage resources including flexible and agile pool of Program Managers, assign projects and efficiently move it through the project lifecycle from end-to-end
- Oversee effective implementation of programs that have a variety of approaches and requirements in partnership with internal and external partners
- Build and develop relationships across teams to ensure effective support and feedback loops and that deliverables are met
- Ensure Program Managers complete implementation activities needed to efficiently move programs through the project lifecycle
- Use problem solving skills and make decisions to move implementation forward
- Expert in reviewing, evaluating and documenting business requirements and facilitating discussions with operational and technology partners, based upon business requirements for IT-related projects
- Ensure compliance with financial goals
Partnership Skills
- Develop and maintain solid relationships with executive leadership of internal teams and external vendors
- Partner with executive leadership from all LOBs to achieve mutual success on achieving/exceeding targets
- Develop and maintain solid relationships with provider groups/facilities for collaboration on clinical pilots and programs
- Oversee frequent cadence of communications to allow deeper understanding of shared objectives, emerging issues internal and external
Payment Integrity Partnership
- Lead efforts to understand and solve for the complexities of coding and reimbursing laboratory services
- Ensure alignment with published guidelines and Society recommendations
- Use problem solving skills and negotiation skills to resolve discrepancies
- Represent UHC Value Creation Laboratory team in internal and external discussions
Quantitative Analysis
- Develop cost benefit analyses and business cases for clinical programs
- Develop and analyze Key Performance Indicators for clinical program for each line of business to define timelines and documentation necessary for financial compliance and performance
- Interacting with HCE and LOB Finance teams to verify and report out on aggregate program performance
- Solve complex financial performance barriers
- Work with program managers and predictive analytics teams to accurately model performance expectations to set realistic financial goals
- Provide guidance to program managers in evaluation of data from analytic teams to correlate the expected affordability to the operational reality of the program
Research Skills
- Ability to search for, analyze and present innovative ideas regarding implementation of clinical laboratory programs in pipeline
Presentation Skills
- Speak clearly on complex problems across a wide range of audiences
- Provide regular updates regarding the implementation process and clinical programs for Joint Operating Committees, Team Leadership and Executive Sessions
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:- Undergraduate degree
- 5+ years of healthcare experience
- 4+ years in a leadership / management role
- 3+ years of laboratory/genomics experience
- Demonstrated superior data analysis skills and experience with healthcare quality metrics
- Demonstrated sound strategic, analytic and critical thinking skills with proven ability to use clinical, administrative and claims data to identify opportunities, inform program design and measure process, clinical and financial outcomes
- Demonstrated solid history of quickly building relationships, gaining credibility and partnering with business leaders. Must excel at building teams and collaborating across multiple distinct business groups
- Demonstrated ability to work with Agility team to design, build and implement IT support for clinical programs
- Demonstrated ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizations
- Demonstrated solid negotiation skills; the ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome
- Demonstrated ability to manage others; ability to influence in executive settings
- Demonstrated strategic thinking with proven ability to communicate a vision and drive results
- Demonstrated creative problem-solving skills
- Proven self-starter, initiates work independently
Preferred Qualification:*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 - $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
