National Medical Director, Surgical Clinical Programs - UHC

Job ID: Posted: Location: Minnetonka, Minnesota, United StatesSalary: $386,500 - $579,500/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth GroupAt 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 National Medical Director of Surgical Clinical Programs is responsible for leading the design, development and oversight of clinical specialty programs to improve the affordability and quality of care across general surgery, minimally invasive, and endoscopy procedures.  The National Medical Director leads a small entrepreneurial team that uses the company's health care analytical tools, medical literature, clinical experience, and provider and member feedback to identify, design and implement clinical programs to lower cost, simplify healthcare delivery and improve quality and outcomes.  The team is also accountable for post-deployment review of results.  This position reports to the National Medical Director of Specialty Content and Care Pathways in UnitedHealthcare Clinical Services.This role requires a strategic and critical thinking mindset with the ability to handle multiple priorities as well as the ability to articulate and represent UHC clinical strategy to executive leaders across the enterprise and to external stakeholders.  You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.For all hires within 30 minutes of an office in Minnesota or Washington, D.C., you'll be required to work a minimum of four days per week in-office.Primary Responsibilities:Clinical Strategy Leadership in Program Design and DevelopmentPossess solid clinical and operational knowledge having worked in the designated specialty of General Surgery, including minimally invasive, endoscopic and robotic types of proceduresOversee the strategy for health plan surgical specialty programs using knowledge and understanding of the healthcare industry, emerging technology and trends, and current medical specialty guidelines and peer-reviewed literature, incorporating feedback from key stakeholdersLead the design of clinical program development for modernizing utilization management and retrospective clinical review programs and for site of care across the continuum of surgical, minimally invasive and endoscopy procedures, related diagnostics and surgical technology (robotics and smart surgical devices) to improve health outcomes with a focus on member and provider experienceProvide leadership and clinical insights for general surgery, endoscopy and site of care clinical category activities across the enterprise such as value-based care programs, quality improvement initiatives, and optimizing site of careProcess OptimizationIdentify pain points in current prior authorization processes and propose innovative solutionsSupport effective implementation in partnership with teams in clinical operations and technologyParticipate in the development of pilot programs and evaluate performance metrics for automation initiativesBuild and develop relationships across teams to ensure effective feedback loops and that deliverables are metSet and review program metrics for continuous enhancements, updates, and improvementData and Technology ProficiencyAssess and interpret complex financial and clinical data to evaluate feasibility of proposed initiativesDirect the healthcare analytics team as they work through hypothesis and problems and synthesize the results and to assure model assumptions are accurateEvaluate clinical, quality and claims data to identify opportunities for improvement of clinical programsProvide clinical insights and input to guide technology partners in development of large language learning models and technical capabilities for care pathways and bundled authorizationsCommunication, Collaboration and Relationship BuildingArticulate and represent UHC clinical strategy to executive leaders across the enterprise and to external stakeholders and be able to speak clearly on complex problemsAdvocate with leadership across the organization to create better alignment with business segments, network, and functional areas, thereby ensuring internal and external coordination and a unified approach to the market and associated constituentsCoordinate efforts of clinical, network, operations and HCE teams to support expansion of value-based programs delivered through our providersCreate and maintain solid relationships with key clinical leaders across the organizationClinical ExpertiseCollaborate with the CMO, clinical, network and business leaders on top priorities and goalsParticipate in key clinical committeesSolicit or respond to input on clinical initiativesInfluence development of clinical communications that will be delivered to external audiences.

(e.g., new clinical policies, programs, processes)Participate in the response development and delivery to high level questions, concerns and complaints from regulators, accreditors, legal/risk management, employers, healthcare providers, and other stakeholdersDiscuss clinical program outcomes, data and performance with providers, employers, accreditors and regulatorsYou'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:Doctorate of Medicine (MD or DO) degree with active/unrestricted medical license in one of more statesBoard certified in General Surgery or related surgical specialty required10+ years of clinical practice experience required7+ years of progressive healthcare leadership experience managing clinical and cross functional teams5+ years of senior level management experience leading clinical operations in a health plan or managed care environmentBusiness training and experience in addition to clinical expertiseDemonstrated understanding of and experience with managed care functions of utilization management, clinical decision support, post service review, and/or care management functions aligned to evidence-based medicineDemonstrated ability to read and understand evidence-based medical literature and how this applies to the development of medical policy and clinical guidelinesFamiliarity with digital health platforms and healthcare data exchangeSolid strategic thinking and business acumen with the ability to align clinical related strategies and recommendations with business objectivesSolid analytic and critical thinking skills with proven ability to use clinical, quality and claims data to identify opportunities, inform program design and measure process, clinical and financial outcomesSolid history of quickly building relationships, gaining credibility, and partnering with business leadersSolid operational focus with demonstrated data analysis / interpretation acumen, project management, change management, and execution skillsSolid organizational, management, administrative, and human relations skills, and a style which exhibits emotional maturity, leadership, collaboration, and teamworkProven ability to communicate effectively and efficiently (both verbally and written) at multiple levels of large, complex organizationsProven ability to drive, lead and to communicate change effectively in a fast-paced environment and be adaptable within the changing environmentProven ability to motivate, mentor, and influence others at all levels within the organizationDemonstrated ability to make strategic, operational, and administrative decisions in response to emerging conditions and environmental circumstancesDemonstrated ability in systems thinking and enterprise insight to solve complex business problems and solid analytical skills with ability to drive transformational, consumer-centric change and manage long-term programsPast success working collaboratively in a highly matrixed environmentPreferred Qualifications:Experience in digital health transformation or technology-enabled care models*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay 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 $386,500 to $579,500 annually based on full-time employment. We comply with all minimum wage laws as applicable.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.