Sr. Consultant, Health Management & Operations - Medical Management (Clinical Medical) - Telecommute

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

As a Senior Consultant, Health Management & Operations - Medical Management you'll provide consulting services to strengthen and improve health care operations that result in stronger financial returns and a healthier health care system. You'll use your strong strategic and business acumen to work closely with clients to define, develop and document business requirements to ensure needs are captured and critical deliveries are executed. This consulting career gives you the opportunity to travel and share in a mission that inspires. You'll see your ideas come to life and your achievements recognized. You won't find tougher challenges. And you won't find smarter people working together to solve them. Join us and start doing your life's best work.(sm)

Bring your deep domain expertise and previous management consulting experience to help improve clinical operations, including:
  • Clinical Operations expertise in Utilization Management, Concurrent Review, Case Management, Disease Management and Wellness
  • Appeals and grievance processes
  • End-to-end process management
  • Clinical quality and governance
  • Operations performance management
  • Business reporting and analytics
  • Core administrative systems and supporting applications or services
  • Outlier and high dollar review processes
  • Policy and procedures

You'll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

Primary Responsibilities:
  • Effectively build and maintain relationships with clients and co-workers
  • Conduct research studies that may include collecting, analyzing, trending and presenting data and recommendations to management
  • Collaborate with business and technology teams to identify issues, establish objectives, develop recommendations and implement solutions for our clients
  • Develop business strategies, plans and cost benefit analyses
  • Support client implementations of products and/or services
  • Provide work stream / project oversight, manage and track issue resolution and make key decisions for the project with the project sponsor
  • Create written and oral communication artifacts that effectively summarize findings, support fact-based recommendations and provide appropriate detail to substantiate conclusions
  • Drive / participate in presentations and meetings with all levels of the organization
  • Facilitate status updates and review of programs to client senior leadership team and/or project sponsor(s)
  • Drive outcomes with and without direct authority, engaging team members in a cross-functional environment
  • Provide coaching and mentoring of project team with the goal of developing and retaining talent within the organization

The consulting environment is challenging and fast-paced, requiring the following core competencies:
  • Self-Motivation and Ambition - Highly self-motivated and ambitious to ensure all projects are successful
  • Critical Thinking and Problem Solving - Dig into challenging situations, synthesizing information to provide guidance and recommendations to clients
  • Adaptability - Flex in response to changes and maintain focus
  • Creativity and Persuasiveness - Uncover and respond to business needs, define solutions, and educate constituents; be known by others as a trusted advisor
  • Personal Accountability - Model strength during challenges and take personal responsibility for actions and consequences
  • Executive Presence - Articulate and package communications in a clear and crisp manner for all levels of the organization with the ability to adapt approach and style to any audience
  • Organization - Apply best practices for planning, executing and controlling work to maximize outcomes and value

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:
  • Clinical licensure as a RN, BSN, LSW, LCSW, PT, or OT
  • 5+ years of Healthcare experience in any of the following: Government Programs, Clinical Operations, Medical Management, Cost of Care, or Program Management
  • 3+ years of experience working in a leadership role at a health plan or provider organization
  • 3+ years of project management and team leadership experience
  • 3+ years of experience leading consulting engagements or internal healthcare projects / programs
  • 3+ years of experience in a client or customer-facing role
  • 3+ years of experience in one or more of the following: Operational business process improvement, business process analysis, benchmark analysis or workflow analysis
  • 1+ years of experience with client relationship management and expanding sales opportunities beyond current engagement
  • Experience writing and developing client facing materials in Microsoft Word, PowerPoint, Excel, Visio and Project
  • Proven analytical problem-solving skills (identification of issue, causes, solution, implementation plan)
  • Project coordination and management skills (strong project tracking, presentation and reporting skills)
  • Ability to travel is required for this role and is generally less than 50% on average but may involve Monday through Thursday travel for short periods to satisfy specific client project requirements
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:
  • Broad experience in health plan operations, including quality, claims, member services, benefit management, member enrollment, provider network, finance and others
  • Health plan experience across multiple lines of business
  • Work experience in a professional consulting organization in a healthcare operations leadership role
  • Experience in Digital process enablement and transformation
  • Experience in large, matrixed environment
  • Quantitative ability to analyze data
  • Strong knowledge of Microsoft Office products with a focus on PowerPoint and Excel
  • Strong work ethic and desire to help clients improve their businesses
  • Ability to work in complex, fast-paced environments
  • Strong interpersonal and communication skills

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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.

Job Keywords: Senior Consultant, Health Management & Operations, Medical Management, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH