Job Details

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 togetherThe Clinical Program Director of Brain and Behavior is responsible for ideating, designing, and developing innovative specialty clinical programs focused on Neurological and Behavioral Health Conditions. This role aims to improve affordability, health outcomes, and member and provider experience. The Director manages a small team of program managers and works with healthcare analytics, clinical implementation technology, and medical management teams to develop and monitor Brain and Behavior focused Clinical Programs at UnitedHealthcare. The Director reports to the National Medical Director of Behavioral Health at UnitedHealthcare Clinical Services. The ideal candidate combines clinical expertise, strategic thinking, a flexible mindset, and program development skills to create impactful solutions for members and providers.You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary ResponsibilitiesClinical Program Ideation and DesignUse clinical, claims and quality data and knowledge of emerging trends in the specialty care industry to identify key opportunities to design large-scale, enterprise-level clinical management programs that drive meaningful affordability, quality, and experience outcomes across diverse populations and lines of businessLeverage advanced analytics, including artificial intelligence (AI) and large language models (LLMs) when appropriate to enhance program design efficiency, automate insights, and identify innovative clinical pathways that support proactive and personalized careUse clinical, claims, and quality data to identify high-impact cost drivers, utilization trends, and care variation at scaleConceptualize new clinical programs that incorporate technology-enabled care models, digital engagement strategies, and modern decision-support tools for pre and post service medical management and value-based careBuild feasibility business cases and financial models to assess operational readiness and impact when implemented at scaleIncorporate evidence-based medical policies, clinical guidelines, and a broad spectrum of actionable insights – including claims data, clinical outcomes data, utilization trends, quality metrics, member-reported outcomes, digital engagement signals, market intelligence, provider performance patterns, and operational throughput data – gathered across markets, providers, and enterprise data sourcesFoster stakeholder alignment and cross-functional collaboration to ensure programs are designed to support national scalability, operational sustainability, and continual innovationData-driven strategyAnalyze claims utilization and variation, clinical, and quality data to identify opportunities for clinical program development and improvementUse clinical insights and knowledge to inform program design and measure impactWork with program managers and analytics teams to accurately model performance expectations to correlate the expected affordability to the operational reality of the programAnalyze appeal trends, overturn rates, peer-to-peer outcomes, and clinical documentation to develop targeted interventions, provider feedback loops, and continuous improvement plansCollaborate with analytics teams to develop Key Performance Indicators and to build dashboards tracking program performanceStakeholder CollaborationSeek input from network teams, market teams and external vendors to develop program modelsBuild and maintain solid relationships with executive leadership across internal teams to ensure effective support and feedback loops and that deliverables are metDevelop and maintain solid relationships with provider groups/facilities for collaboration on clinical pilots and programsCollaborate with Regulatory and Compliance Teams to ensure program compliance with state and federal regulatory requirementsCommunication and Presentation SkillsSpeak clearly on complex problems across a wide range of audiencesPrepare decks and executive summaries for regular updates regarding the clinical program development and performance for Joint Operating Committees, Team Leadership and Executive SessionsProgram ImplementationUse problem solving skills and make decisions to support program design and feasibility prior to transition to the Clinical Services Implementation teamActively participate in clinical, business and operational meetings; ensure business partners, stakeholders and senior management are provided relevant and timely information on the clinical program design and scope for the approval processProvide support to the Clinical Services Implementation team and project managers responsible for moving the program initiative through the clinical implementation lifecycle end-to-endActively 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 organizationWork independently and as a team memberProgram oversight and Continuous ImprovementMonitor clinical program performance and Key Performance Indicators and iterate based on feedback and dataEnsure program compliance with state and federal regulatory requirements; collaborate with Regulatory and Compliance Teams to develop and implement new regulatory and compliance requirementsSolve 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, including senior managementRequired QualificationsExperienceAdvanced Degree including Master's degree or PhD in healthcare administration, public health, social services, nursing or a related clinical specialty, or MBA plus clinical background in neurological diseases.5+ years in a leadership or management role in healthcare5+ years of healthcare experience with operational accountabilityDemonstrated ability to design, scale, or operationalize enterprise-level clinical programs or value-based care models across multiple markets or lines of businessClinical ExpertiseDeep clinical understanding of brain and neurodegenerative conditionsFamiliarity with evidence-based clinical guidelines and policiesProven ability to apply clinical insights to program design and outcome measurementRegulatory KnowledgeFamiliarity with health plan regulatory and accreditation requirementsData & Analytics ProficiencySkilled in analyzing claims, clinical, and quality data to drive new clinical insights and identify opportunities for program development and inform program designProven ability to work with healthcare analytics teams to model performance expectations and measure clinical and financial impactLeadership SkillsDemonstrated experience setting clear goals, providing regular feedback, and conducting performance evaluations to support career growth and talent retentionSkilled in guiding teams through ambiguity, change, and complex problem-solving while maintaining clarity, engagement, and accountabilityProven ability to lead, coach, and develop small teams of program managers or clinical professionals, fostering a supportive, high-performance cultureProven solid commitment to collaboration – encouraging cross-functional communication, resolving conflicts constructively, and building trust within and across teamsProven self-starter, initiates work independentlyCommunication and PresentationProven ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizationsSolid negotiation skills: Proven ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcomeTechnical SkillsProficiency with MS-Word, Excel, and PowerPointPreferred QualificationExperience applying AI-enabled analytics, machine learning tools, or large language model (LLM) capabilities in healthcare program design, clinical operations, or outcome measurementAll 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 $134,600 to $230,800 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.J-18808-Ljbffr