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Sr. Clinical Portfolio Project Manager - Remote

Company: UnitedHealth Group
Location: Charlotte
Posted on: September 23, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:


  • Lead a cross-functional team of UHG stakeholders to implement visibility and transparency into pre- and post-service clinical decision processes
  • Evaluate competitor policies, internal data, and recommend adjustments to UCS clinical policies and clinical models to achieve efficiency and affordability targets
  • Review pre and post service review practices to reduce post-service denial overturns
  • Establish a regulatory and accreditation oversight program for post service clinical review practices
  • Organize and lead review of all current clinical and non-clinical UM processes and training documents for Inpatient Care Management, Prior Authorization, Appeals, Medical Claims Review, and Exchange UM teams
  • Establish a future state end-to-end process for receipt of regulatory, contractual, or other changes and translate those requests into rules for automation
  • Create business case and financial models to demonstrate value of work effort and staff needed to achieve that value


    A Day in the Life: -
    Sr. Clinical Portfolio Manager


    • Prioritize daily work using critical thinking skills:


      • Assign tasks to team members as appropriate; communicate expectations and timelines/deadlines for completion
      • Provide leadership support and guidance to team members


      • Coordinate and lead necessary project meetings and coordinate status reports and risk mitigation strategies from several key stakeholders
      • Drive project deliverables to on-time completion and collaborate with team/department members to identify and -address barriers to project success. -Act as initial escalation point for identified barriers
      • Author Sr. Leadership presentations relating to project status
      • Analyze and synthesize various data points to measure project success
      • Engage with different parts of the organization to build relationships and break down information and activity silos
      • Think creatively and curiously about business opportunities and communicate openly with leadership on strategies to operationalize change



        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:


        • Industry certification in a project management methodology (i.e. PMI, ASQ, IASSC)
        • 3+ years of experience in Project Management of claims, credentialing or clinical operations, state, and federal regulatory audits, or NCQA accreditation
        • 2+ years of experience with P&L management, metric-driven goal setting, and cost benefit analysis
        • Proficiency with Microsoft products, including Excel add-ons like PowerPivot
        • Ability to Travel up to 25% of the time and abide by all UHC vaccination requirements
        • Must have a designated workspace and access to install secure high-speed internet via cable/DSL in home
        • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation


          Preferred Qualifications:


          • Extremely detail orientated with focus on quality/quality assurance
          • Excellent written and verbal communication skills including the ability to present information to large audiences and C-suite stakeholders
          • Ability to respond quickly to new instructions, situations, methods, and procedures
          • Ability to manage competing demands on time


            Skills You Will Develop:


            • Demonstrate strategic flexibility under change and uncertainty
            • Demonstrate energy, persistence, and optimism in times of sustained demands and pressure
            • Encourage idea sharing and recognize novel approaches to organizational problems
            • Work in an ever changing, fast- paced environment with a flexible approach to managing tasks and processes



              To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

              Careers with UnitedHealthcare. -Let's talk about opportunity. Start with a Fortune 5 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)

              Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $97,300 to $176,900. The salary range for Connecticut / Nevada residents is $97,300 to $176,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

              *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.


              Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

              UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Charlotte , Sr. Clinical Portfolio Project Manager - Remote, Healthcare , Charlotte, North Carolina

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