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Clinical Program Manager - Remote in Southern Colorado

UnitedHealth Group
401(k)
United States, Colorado, Alamosa
Apr 03, 2025

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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

Supports Clinical Quality Improvement objectives by facilitating and coaching designated clinical practices in the implementation of redesign and quality improvement strategies to improve patient, provider and health care team satisfaction, improved patient outcome, provider office efficiency, and management of total cost of care. Is responsible for the development and ongoing administration of clinical quality improvement programs. Provides program implementation support, measurement standards, and revisions that incorporate best practices with proven outcomes. Assists in assessment of progress and recommends strategies to achieve collaborative goals and facilitate sustainability. Uses project management skills and works collaboratively with the Manager and other intra and extra department managers to coordinate assigned projects and initiatives. Maintains active involvement with internal and external Clinical Quality Improvement activities by collaborating proactively with external stakeholders and internal departments as directed by the Clinical Quality Improvement Program Manager.

If you reside in the state of Colorado, you'll enjoy the flexibility to work remotely * as you take on some tough challenges.

Primary Responsibilities:



  • Works collaboratively with various internal and external entities and individuals in accordance with the Mission and Values of the company to assist in maintaining and enhancing RMHMO's reputation as the leader in managed health care. Provides leadership by example to embed the organizational philosophy and culture
  • Respect confidentiality and maintain confidence as described in the Confidentiality Security Agreement that is signed by all employees. The ability to maintain confidentiality is a critical and essential component of this position
  • Responsible for providing delivery of the designated Clinical Quality Improvement program and/or projects to guide health care team redesign efforts toward population management, and training on quality improvement principles
  • Create highly functioning practices and communities focused on maximizing the integration and effective utilization of developing HIT\HIE technologies at the point of primary care delivery to improve cost, quality and experience of care
  • Routinely performs practice assessments, in collaboration with practices, comparing program or contractual requirements/deliverables with evidence of work provided by the practice for the purpose (s) of identifying opportunities for improvement and/or program or contract compliance. May be involved in the development and testing of assessment tools and processes
  • Provide practice support to facilitate the coordination, development, teaching, implementation, and evaluation of provider practices participating in Clinical Quality Improvement Programs. Introduce and educate new provider practices to the program as directed
  • Provide support to practice participants through email, phone, site visits, review and feedback on assessments and monthly status reports and other methods as identified
  • Provides support to the clinical performance management team in their area of expertise (data, behavioral health, etc.) by collaborating with internal staff on the design and implementation of programs that build positive relationships between the health plan, providers, member and community stakeholders
  • Identifies innovative ways to work with providers to meet the needs of our members and the health plan
  • Participates in cross-functional workgroups as a 'practice expert' to inform internal stakeholders of success, barriers and impact of initiatives on our members, the health plan and providers
  • Uses a systematic approach and critical thinking skills to assist in guiding the team to create highly functioning practices and communities driven at the point of primary care delivery to improve cost, quality and experience of care
  • Utilizes interpersonal and meeting facilitation skills to attend and participate in meetings as necessary and as directed by the manager. Provides information and recommendations based on knowledge in their area of specialty. Integrates and collaborates with other clinical departments as requested by the Manager
  • Identifies innovative ways to engage and meet the needs of our members and providers
  • Develop and maintain strong working relationships with provider practices, RMHP employees, and other community participants
  • Utilizing established measurements to obtain baseline provider practice information and monitor ongoing progress towards achieving sustainability
  • Facilitate the practice's use of available health information technology resource opportunities to improve overall practice efficiency and improved patient outcomes
  • Utilize individual thought to develop, organize and evaluate data to resolve problems or determine course of action with the practice QI team
  • Actively participate in scheduled Clinical Quality Improvement Department Team Meetings and other ongoing planning and development meetings
  • Develop and maintain strong working relationships with state entities such as the Department for Healthcare Policy and Financing (HCPF)
  • Use excellent organizational skills, professional demeanor and tact to support various Clinical Quality Improvement activities. Use self-direction, intuition, and flexibility to anticipate needs and act proactively to ensure departmental goals are met. Provide research and assistance to project managers as assigned Coordinate multiple, cross functional projects that result in achieving departmental goals
  • Assist with event planning and logistics for provider education including location, speakers, content, registration, and other logistics as needed
  • Provides support in area of expertise (data, behavior health, etc.) to the health plan to meet contract deliverables inclusive of all value-based contracts, as well as other external contract deliverables
  • Works with minimal guidance and solves moderately complex problems; seeks guidance for only the most complex tasks
  • Maintain the confidentiality of sensitive information obtained in the course of managing the project
  • This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage



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:



  • Bachelor's degree in health care management, nursing, behavioral health, related field or the combination of education and experience that would enable performance of the full scope of the position
  • 5+ years post graduate progressive medical related experience
  • 2+ years of experience in public health, quality improvement, and ambulatory settings
  • Excellent written communications skills and presentation skills
  • Ability to work collaboratively with diverse individuals and functions at all levels of the organization and external customers
  • General knowledge of business, health care and health care coverage issues
  • Driver's license and access to reliable transportation
  • Resident of Colorado



Preferred Qualifications:



  • Prior experience with quality improvement processes
  • Prior experience with Health Information Technology
  • Prior clinical office experience



*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. 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.

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.

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.

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