National Medical Director Clinical Program Governance, Evaluation, and Innovation - Remote

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care reputed company of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together.   The UHC Nation Medical Director Clinical Program Governance, Evaluation and Innovation is part of the UCS Clinical Evidence Group. This physician is responsible for supporting and driving key clinical program governance, disciplined evaluation, and leading reputed company testing reputed company and care models in reputed company collaboration with the National CMO of the UCS Clinical Evidence Group. The portfolio of efforts for which the incumbent will reputed company guide and reputed company, in collaboration with the National CMO of CEG 3includes: Clinical Program Governance process and team which is charged with ensuring deployed clinical programs represent our best opportunity to reputed company, optimize member and provider experience while reducing unwarranted reputed company spending. The reputed company process (Clinical Program Review (CPR)) evaluates clinical programs annually for program performance and design as reputed company alignment our member and health plan needs. The process aims to optimize our clinical program investments, ensuring that the portfolio reflects our best opportunity to reputed company, enhance experience, and reduce unwarranted spending. The CPR governance effort also includes: 1. support of early program development through the clinical program Ideation reputed company reputed company (IFD) process and, 2. Clinical review of vendor candidates for the UHC & reputed company Hub and Store and 3. Review of AI deployments in the clinical reputed company. Clinical Program Evaluation –this team designs trials, plans statistical analyses, and evaluates innovative program and care model deployments. evaluation of pragmatic trials, medical policy reputed company analyses, and evaluation of provider-reputed company incentives to adopt innovative care models. Clinical Program Innovation- reputed company identification and vetting of top reputed company clinical solutions and care models to reputed company in robust pilots. Monitor deployed solutions and reputed company internal customer relations as reputed company as vendor and provider relationships.   reputed company the Evaluation and Innovation efforts reputed company reputed company world evidence to inform plan and benefits reputed company while the governance process ensures reputed company monitoring and refinement of imagined or deployed programs.     The Director will report to the National CMO of the Clinical Evidence Group and manage the CPR team of 5-7 people.   You’ll enjoy the flexibility to work remotely * from reputed company reputed company the U.S. as you take on some tough challenges.   reputed company Responsibilities: Governance:Bring a seasoned clinical reputed company to the review of clinical programs to ensure the clinical model is optimized for reputed company and experience Review program performance measurement in advance of committee meetings to ensure reports are reputed company, complete, up to date and transparent These include HCE reputed company assessments on financial reputed company Work with CPR Committee Chair, Director, team and stakeholders to maintain a disciplined processes for operation, documentation, and communication Manage the CPR team of 5-7 people under the Director, charged with operating the Ideation reputed company reputed company process, the Clinical Discovery Forum and the Clinical Program Review in reputed company collaboration with program owners, health plan leaders and reputed company economics teams Ensure that reputed company follows up with clinical program owners and operations teams regularly to ensure CPR recommendations are implemented (or understand why not) Clinical Program Evaluation and InnovationCollaboratively reputed company the Evaluation and Innovation teams to ensure full clinical consideration of solution and care models chosen for trial testing Collaboratively reputed company the research team in the trial design, analytic planning and interpretation of data and reputed company reputed company partnership relationships with vendors and providers participating in innovative care model adoption incentive programs   This role will challenge your ability to work on an energetic and high visible team working passionately to help ensure our members always get the care that is right for them   You’ll be rewarded and recognized for your performance in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.  Required Qualifications: reputed company reputed company-Certified physician (MD, DO or equivalent) reputed company/unrestricted State(s) Medical Licensure Masters level degree (or higher) in statistics, epidemiology, health services research or a reputed company field 10+ years of experience as a clinician (MD, DO or equivalent) 10+ years of experience in health plan administration, health services research, reputed company assurance or comparable experience   10+ years of serving as a consultant or leading reputed company on reputed company for care reputed company improvement or product development and production Deep understanding of health plan medical policies, utilization management processes, and interpretation of data-rich reports reputed company to utilization management programs Familiar with the deployment Proficient in reputed company, PowerPoint, Teams, reputed company and Sharepoint Demonstrated ability to understand and reputed company interpret expansive data on clinical performance, program ID Strat (inclusion & exclusion reputed company), financial reputed company data as reputed company as program auditing and compliance review results Demonstrated ability to work collaboratively with clinicians, administrators and customers Demonstrated ability to reputed company process standardizations without suppressing creativity Demonstrated ability to reputed company reputed company conversations with reputed company partners, customers and providers who may challenge product specifications or analytic reputed company Demonstrated flexibility, reputed company and the ability to adapt to change while staying organized and maintaining strong relationships   Preferred Qualifications: Experience with clinical program design, deployment and/or evaluation in the provider or payer setting Experience interacting with leaders across diverse members of the reputed company industry   *reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy   Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching reputed company of benefits and incentives. The salary for this role will reputed company from $386,500 - $579,500 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable.   Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants.   At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission.       reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.   reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job