The Clinical Program Director of Musculoskeletal Health is responsible for ideating, designing, and developing innovative tech-enabled specialty clinical programs focused on musculoskeletal health. This role aims to improve affordability, health outcomes, and member and provider experience. The Director manages a small team of program managers and works with healthcare analytics, clinical implementation technology, and medical management teams to develop and monitor Musculoskeletal Health Clinical Programs at United Healthcare. The Director reports to the National Medical Director of Musculoskeletal Health at UnitedHealthcare Clinical Services. The ideal candidate combines clinical expertise, strategic thinking, an innovative mindset, and program development skills to create impactful solutions for members and providers.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:- Clinical Program Ideation and Design:
- In partnership with the National Medical Director of Musculoskeletal Health, uses clinical, claims and quality data and knowledge of emerging trends in the specialty care industry to identify key opportunities to design large-scale, enterprise-level clinical management programs that drive meaningful affordability, quality, and experience outcomes across diverse populations and lines of business
- Leverage emerging technologies, including advanced analytics, artificial intelligence (AI), and large language models (LLMs) to enhance program design efficiency, automate insights, and identify innovative clinical pathways that support proactive and personalized musculoskeletal care
- Use clinical, claims, and quality data to identify high-impact cost drivers, utilization trends, and care variation at scale
- Conceptualize innovative new clinical programs that incorporate technology-enabled care models, digital engagement strategies, and modern decision-support tools for improve affordability of care, provider engagement and member experience
- Build feasibility business cases and financial models to assess operational readiness and impact when implemented at scale
- Incorporate evidence-based medical policies, clinical guidelines, and a broad spectrum of actionable insights - including claims data, clinical outcomes data, utilization trends, quality metrics, member-reported outcomes, digital engagement signals, market intelligence, provider performance patterns, and operational throughput data - gathered across markets, providers, and enterprise data sources
- Foster stakeholder alignment and cross-functional collaboration to ensure programs are designed to support national scalability, operational sustainability, and continual innovation
- Data-driven strategy:
- Analyze claims utilization and variation, clinical, and quality data to identify opportunities for clinical program development and improvement
- Use clinical insights and knowledge to inform program design and measure impact
- Work with program managers and analytics teams to accurately model performance expectations to correlate the expected affordability to the operational reality of the program
- Analyze appeal trends, overturn rates, peer-to-peer outcomes, and clinical documentation to develop targeted interventions, provider feedback loops, and continuous improvement plans
- Collaborate with analytics teams to develop Key Performance Indicators and to build dashboards tracking program performance
- Stakeholder Collaboration
- Seek input from network teams, market teams and external vendors to develop program models
- Build and maintain solid relationships with executive leadership across internal teams to ensure effective support and feedback loops and that deliverables are met
- Develop and maintain solid relationships with provider groups/facilities for collaboration on clinical pilots and programs
- Collaborate with Regulatory and Compliance Teams to ensure program compliance with state and federal regulatory requirements
- Communication and Presentation Skills
- Speak clearly on complex problems across a wide range of audiences
- Prepare decks and executive summaries for regular updates regarding clinical program development and performance for Business meetings, Executive sessions, and Clinical Program Review
- Program Implementation
- Use problem solving skills and make decisions to support program design and feasibility prior to transition to the Clinical Implementation team
- Actively participate in clinical, business and operational meetings; ensure business partners, stakeholders and senior management are provided relevant and timely information on the clinical program design and scope for the approval process
- Provide support to the Clinical Services Implementation team and project managers responsible for moving the program initiative through the clinical implementation lifecycle end-to-end
- Actively participate in multidisciplinary teams to achieve program deliverables; Foster and promote collaborative relationships with matrix partners/stakeholders; Establish trust and credibility at all levels of the organization
- Work independently and as a team member
- Program oversight and Continuous Improvement
- Monitor clinical program performance and Key Performance Indicators and iterate based on feedback and data
- Ensure program compliance with state and federal regulatory requirements; collaborate with Regulatory and Compliance Teams to develop and implement new regulatory and compliance requirements
- Solve unique and complex problems with broad impact on the business; translate highly complex concepts in ways that can be understood by a variety of audiences, including senior management
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 in nursing or physical therapy with musculoskeletal clinical experience
- 5+ years in a leadership or management role in healthcare
- 5+ years of healthcare operational experience in orthopedics, Physical therapy, or related musculoskeletal field with operational accountability
- Experience with demonstrated ability to design, scale, or operationalize enterprise-level clinical programs or value-based care models across multiple markets or lines of business
- Regulatory Knowledge
- Familiarity with health plan regulatory and accreditation requirements
- Deep clinical understanding of musculoskeletal conditions, evidence-based medical policies and clinical guidelines
- Clinical expertise with the ability to apply clinical insights to program design and outcome measurement
- Technical Skills
- Proficiency with MS-Word, Excel, and PowerPoint
- Data & Analytics Proficiency
- Proven skilled in analyzing claims, clinical, and quality data to drive new clinical insights and identify opportunities for program development and inform program design
- Demonstrated ability to work with healthcare analytics teams to model performance expectations and measure clinical and financial impact
- Leadership Skills
- Demonstrated experience setting clear goals, providing regular feedback, and conducting performance evaluations to support career growth and talent retention
- Proven ability to lead, coach, and develop small teams of program managers or clinical professionals, fostering a supportive, high-performance culture
- Proven skilled in guiding teams through ambiguity, change, and complex problem-solving while maintaining clarity, engagement, and accountability
- Proven solid commitment to collaboration - encouraging cross-functional communication, resolving conflicts constructively, and building trust within and across teams
- Proven self-starter, initiates work independently
- Demonstrated ability to manage and supervise multiple concurrent projects, ensuring each progresses on schedule through coordinated planning, cross functional alignment, and effective execution toward successful implementation
- Communication and Presentation
- Demonstrated ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizations
- Proven solid negotiation skills: the ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome
Preferred Qualifications: - Master's degree in healthcare administration, public health, or business
- Experience applying AI-enabled analytics, machine learning tools, or large language model (LLM) capabilities in healthcare program design, clinical operations, or outcome measurement
*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 $xx,xxx to $xx,xxx 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.
