The Director of Population Health Care Transformation provides executive leadership for all ambulatory clinical service lines, including care management, transitional care management, chronic disease management, pharmacy support, and value-based care programs. Responsible for strategic planning, operational performance, quality outcomes, regulatory compliance, and financial performance of ambulatory clinical programs while partnering with physicians, operations, and payer organizations to achieve organizational goals.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities: Lead Ambulatory Care & Clinical Services
- Direct oversight of ambulatory care management, transitional care management, pharmacy support, and future ambulatory clinical programs
- Supervise department managers and ensure efficient daily operations, staffing, productivity, and performance
Population Health & Value-Based Care Strategy
- Develop and execute ambulatory population health strategies supporting Medicare Advantage, MSSP, commercial risk contracts, bundled payment models, and other value-based initiatives
- Ensure clinical programs are aligned with contractual performance measures and organizational priorities
Collaboration
- Oversee cross-organization and cross-team collaboration with the client and internal partners to align priorities, coordinate execution, remove barriers, and ensure shared accountability for clinical, operational, and value-based care outcomes
Clinical Program Development & Transformation
- Design, implement, and optimize ambulatory clinical programs and workflows
- Lead implementation of new clinical initiatives, technology solutions, and evidence-based care models
- Drive continuous improvement across ambulatory services
Payer & Physician Partnership
- Serve as the clinical operational lead for payer-sponsored programs
- Partner with physician leadership, finance, contracting, quality, and ambulatory operations to maximize clinical and financial performance under value-based contracts
Quality, Outcomes & Financial Performance
- Accountable for performance across:
- Readmissions
- ED utilization
- HEDIS and STAR measures
- Total cost of care
- Medication adherence
- Care management outcomes
- Patient engagement
- Develop action plans to improve organizational performance
Leadership & Team Development
- Provide leadership, mentoring, and accountability for managers and clinical leaders
- Build scalable ambulatory programs while fostering collaboration and professional development
- Regulatory & Operational Excellence
- Ensure compliance with CMS requirements, accreditation standards, payer expectations, and organizational policies
- Establish standardized workflows, documentation practices, and performance metrics across ambulatory services
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: - Current, active, unrestricted Registered Nurse (RN) License in the U.S.
- 8+ years of progressive healthcare leadership experience
- 5+ years in ambulatory clinical operations and population health or value-based care program leadership.
- Demonstrated experience leading multidisciplinary teams, building scalable clinical programs, partnering with physicians and payers, and managing performance across quality, utilization, cost, compliance, and patient engagement outcomes
- Able/willing to work Mountain Time Zone business hours regardless of remote base work location
- Must be able/willing to travel approximately 25% of the time as business needs dictate, primarily to the client site in Boulder, CO
Preferred Qualifications: - Experience with Medicare Advantage, MSSP/ACO models, commercial risk contracts, bundled payments, HEDIS, STAR measures, CMS requirements, and payer-sponsored clinical programs
*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.
