UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and com
Senior Clinical Program Manager
Location
United States
Posted
32 days ago
Salary
$112.7K - $193.2K / year
Seniority
Lead
No structured requirement data.
Job Description
Senior Clinical Program Manager
UnitedHealth Group
Role Description As a Senior Clinical Program Manager – Devices and Durable Medical Equipment, you will support and develop programs and initiatives that optimize the utilization and access to medical devices, technology, and equipment in health care. This role supports all lines of business (Medicare, Medicaid, Commercial). The position requires deep knowledge of healthcare devices and durable medical equipment, the evolving market, CPT codes, FDA regulations, and the payment models associated with these technologies. Solid analytical, strategic, and problem-solving skills are required in this role. This is a high-impact opportunity for a self-starter who thrives on driving meaningful change, collaborating across teams, and leading innovative clinical programs. This role will report to the Clinical Director of Health Technology Innovation on the Value Creation team in United Clinical Services. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities - Develop device and DME programs that support utilization management in accordance with Medicare and Medicaid guidelines, internal policies, and regulatory requirements. - Support program ideation and planning in care pathways and value-based initiatives ensuring alignment with regulatory requirements, clinical best practices, and business objectives. - Serve as a subject matter expert and liaison to address cross-enterprise stakeholder inquiries related to policies and practices of medical device and DME management. - Proactively identify system and operational issues in the management and deployment of these devices, working with IT and clinical teams to implement sustainable solutions. - Optimize process flows, claims edit changes, code updates, and triage other operational activities to improve program performance. - Draft internal and external program communications. - Collaborate with internal teams, including but not limited to product, program, IT, clinical, payment integrity, legal, regulatory, compliance, networks, and payment policy, among others to facilitate unhindered program operations. - Identify new opportunities that align with strategic areas of affordability, quality, and access in medical devices and DME. - Maintain and update categories for existing and emerging DME, devices, and medical technologies, anticipating trends and market needs, and informing health plan policy and operational teams to provide equitable access to high-value devices while reducing utilization of unproven or low-value products and services. - Explore and evaluate external partners and internal resources to develop innovative care models where devices, equipment, or technology are required including remote and asynchronous care delivery. Qualifications - Masters degree: Nursing, Business, Public Health or related field. - Solid experience with data analysis and interpretation, using insights to improve program operations and inform policy decisions. - Proven expertise in durable medical equipment and/or medical devices and the associated billing processes and management via health plans. - Proficiency with MS Office (Excel, Word, PowerPoint, SharePoint). - Proven ability to manage complex initiatives in a matrixed environment. - Proven ability to take initiative and drive change - a self-starter who thrives on problem-solving. - Proven solid communication and presentation skills, including the ability to translate concepts into business and policy strategies. Preferred Qualifications - 5+ years of experience in managed care including clinical program management, utilization management, payment integrity, or related experience. - Advanced proficiency with MS Office (Excel, Word, PowerPoint, SharePoint, Visio, OneNote). - Proficiency in Smartsheet for tracking and managing operational data. Travel - Approximately <5% of time will be spent traveling. Authority - Expected to work with minimal direction. - Responsible for making recommendations such as process improvements, resource allocation, and project prioritization. Supervisory Responsibility - No supervisory responsibility. - Provides guidance, leadership, or training to other employees. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). 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. Company Description 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.
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Program Manager
CencoraCencora, formerly known as AmerisourceBergen, is a publicly-traded pharmaceutical service company with locations spanning the globe. As an employer, the company offers "careers wit
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Experience and Educational Requirements: - Proven experience owning end-to-end delivery of a complex platform across 10+ interdependent workstreams, including dependency management, tradeoffs, and executive governance. - Bachelor's degree (or equivalent practical experience) in Business, Engineering, Computer Science, or a related field; program/project management certification preferred (e.g., PMP, PgMP, CSM/PSM, SAFe). - Track record delivering initiatives through launch, operational readiness, and adoption in regulated and/or operationally complex domains (e.g., B2C commerce, healthcare, veterinary, pharmacy-adjacent). - Experience managing program-level financials, capacity, and delivery constraints in partnership with Finance and functional leaders. - Experience effectively using communication and organizational tools, to include Smartsheet, Jira, Confluence and Aha!, to keep stakeholders engaged and up to speed. Minimum Skill, Knowledge and Ability Requirements - Excellent verbal and written communication skills. - Advanced skills in leading client discussions with proven success in facilitating consensus on priorities and the path forward. - Demonstrated ability to clearly present strategy and solution concepts to executives, sales teams and customers. - Skilled in conflict management. - Well versed in finance and accounting core concepts and principles. - Able to prepare a complex master schedule inclusive of dependencies and resourcing. What Cencora offers We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members' ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. 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Equal Employment Opportunity Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law. The company's continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory. Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned Affiliated Companies: Affiliated Companies: MWI Veterinary Supply Company



