Clinical Case Review Jobs in Minnesota

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The Value Creation Team is part of an enterprise-wide team that develops and deploys, with flawless execution, targeted Quality and Affordability initiatives to mitigate medical cost trend and address variations in the quality and appropriate utilization of a variety of services in health care delivery.

The Implementation Program Manager is responsible for deploying projects related to strategic initiatives across business teams and operation groups. This role will provide project management and research and development expertise to support Health Care Affordability and Operations Initiatives.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Please note that this team operates primarily within Central Time (CST) core hours. Candidates in other time zones will be considered if they have the flexibility to align their scheduled to business needs.

Primary Responsibilities:

• Work with key stakeholders such as business and operational leads and intersegment departments, to drive projects from ideation to completion
• Manage Clinical Implementation projects by defining scope, completing risk analysis and creating/maintaining project artifacts including project plans, cost-benefit analysis, process flows, and graphical analysis
• Partner with Analytic teams to perform detailed-level analysis, interpret data results, and determine actionable steps. Employ inquisitiveness throughout analysis to uncover additional opportunities
• Collaborate with project subject matter experts to research obstacles within processes, identify opportunities and implement solutions. Monitor implementation plan against project and financial goals to ensure solutions are progressing effectively
• Speak to and understand clinical applications and processes at a high-level
• Develop high quality presentations containing financial analysis and project performance including defect analysis, scope and schedule adherence, and solution impact. Present findings to appropriate stakeholders in an understandable manner to advance the project
• Facilitate business requirement discussions with operational and technology partners, based upon business requirements for IT-related projects
• Provide regular status updates, including any escalations, to key stakeholders and Senior Leadership
• Identify potential process improvements and promote best practices and lessons-learned with/for key stakeholders

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:

• BA/BS degree in Accounting, Finance, Business or related field and/or equivalent education and experience
• 5+ years of project management experience including tracking, planning projects, working with large data sets and making data-driven analytical decisions
• Demonstrated experience with project management planning, tools, scopes and techniques (cost benefit analysis, staffing estimations, executive engagement, etc.)
• Solid working knowledge of and/or experience in health care industry and experience with Medicaid and Medicare
• Demonstrated ability to build solid relationships & processes through influence, optimize resources using strong interpersonal skills, excellent judgment, & an attitude that fosters teamwork & supports and accomplishes organizational goals
• Proven ability to form relationships with supporting organizations

Preferred Qualifications:

• Experience with Utilization Management
• Experience with clinical operational processes
• Experience with various systems: ICUE, Cosmos, TOPS, NICE, UNET etc.
• Experience with Commercial, Medicaid and Medicare business
• Proficiency with Word, Excel, Visio, PowerPoint and SharePoint; MS Project
• Excellent time management, organizational, and prioritization skills and an established ability to balance multiple priorities to produce positive results in a dynamic environment
• Exceptional written and verbal communication skills, including strong presentation skills demonstrating clear and concise communication to all levels of the organization

• Problem solving skills, including the ability to work independently and systematically to analyze complex problems, draw relevant conclusions, and successfully devise/implement solutions calmly and effectively

• 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). The salary for this role will range from $91,700 to $163,700 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.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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