Senior Clinical Program Consultant - Oncology - Remote

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Senior Clinical Program Consultant is part of the Oncology Value Creation team and is responsible for assisting with ideation, feasibility analysis, development/build and implementation of oncology clinical affordability programs. This role will apply understanding of healthcare systems, data analytics, finance/business acumen, oncology practice operations, revenue cycle management, health plan operations and medical benefits to identify opportunities for oncology clinical affordability programs including Utilization Management/Prior Authorization, Oncology Value-Based models, Quality Improvement, etc. You will collaborate with internal stakeholders across United Health Group, United Healthcare, Optum and external stakeholders to ensure projects are aligned with core strategies and goals, implemented and launched on time and in scope. This role will require a methodical and critical thinking mindset with the ability to handle multiple priorities as well as the ability to drive implementation of initiatives and engage organizational partners to execute on comprehensive Value Creation strategy for oncology initiatives.

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

Primary Responsibilities:

• Create or assist with creation of an overall program/process framework based on research (e.g. purpose, mission, goals, and objectives)
• Define specific program/process requirements and expectations (e.g., who, what, when, where, why)
• Evaluate workflows, efficiencies, and best practices to determine program/process specifications
• Obtain input and feedback from stakeholders during program/process development
• Identify technology needs to support programs/processes (e.g., systems for use of the program) and provide or coordinate system and reporting requirements)
• Ensure program compliance with state and federal regulatory requirements; collaborate with regulatory and compliance teams to develop and implement new regulatory and compliance requirements
• Support multidisciplinary teams in business requirement assessments for new/existing programs, advance enhancements to drive efficiencies, address system deficiencies and/or facilitate corrective actions
• Coordinate, facilitate and actively participate in operational meetings with internal and external stakeholders; ensure customers, vendors and senior management are provided relevant and timely information on program status, risks and mitigation strategies
• Collaborate with internal subject matter experts to research ad hoc system and technology-related program issues; identify root cause and implement proactive solutions; Monitor implementation plan against milestones and/or IT release dates to ensure successful delivery of solution
• 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
• 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
• Create & participate in senior management presentations, as requested
• Independently lead multiple large, highly complex initiatives by defining scope, risk identification, project methodology, resource allocation, cost-benefit analysis, process flows, facilitation and other areas of expertise based on established project management techniques
• End to end owner of project management responsible for completing all implementation activities assigned

• Critical thinking and creative problem-solving skills; demonstrated ability to work independently and systematically analyze complex issues, draw relevant conclusions and implement effective solutions
• Evaluates current business processes to identify re-engineering opportunities; provides support in identifying, developing and implementing process improvements and/or technical capability enhancements
• Excellent verbal and written communication skills; strong presentation and organization skills as well as the ability to convey complex or technical information in a manner others can understand
• Adaptable and flexible; contribute innovative ideas to achieve positive results
• Solid team player/interpersonal skills - ability to influence and work with people of different backgrounds, proven ability to foster teamwork and form alliances with supporting organizations
• Approaches work with a high sense of accountability and attention to detail - takes ownership of tasks, performance standard and quality results
• Accuracy and Efficiency - excellent time management and organizational skills, balancing multiple priorities; maintain accuracy when processing detailed tasks while meeting deadlines
• Self-starter, initiates work independently; able to drive and prioritize work with minimal oversight and demonstrates sound judgment

• 7+ years of healthcare industry experience with accountability for business results
• 2+ years of experience working within oncology (clinical oncology practice, oncology practice operations, oncology clinical program development and/or management or oncology value-based care models)
• Solid experience with data analysis and interpretation; ability to identify errors/anomalies
• Experience collaborating with supporting organizations within a company
• Proficiency with Microsoft Office (Excel, Word, PowerPoint)

• 3+ years of experience in clinical operations
• Managed care health plan management experience
• Experience with UHC business processes and data systems
• Project management experience
• Knowledge and/or experience with claims systems and/or reimbursement methodologies
• Knowledge of, and experience with, process improvement initiatives focused on IT/System enhancements