Clinical Program Director of Cardiovascular Health - Remote

Overview

At UnitedHealthcare, we are simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions. Join us to build the health care system of tomorrow — more responsive, affordable, and optimized. Caring. Connecting. Growing together.

Primary Responsibilities

• Clinical Program Ideation and Design: In partnership with the National Medical Director of Cardiovascular Health, uses clinical, claims and quality data and knowledge of emerging trends in the specialty care industry to identify opportunities to design large-scale, enterprise-level clinical management programs that drive affordability, quality, and experience outcomes across diverse populations and lines of business. Leverage technologies including advanced analytics, artificial intelligence (AI), and large language models (LLMs) to enhance program design, automate insights, and identify innovative clinical pathways for proactive and personalized cardiovascular care. Use clinical, claims, and quality data to identify high-impact cost drivers, utilization trends, and care variation at scale. Conceptualize innovative new clinical programs with technology-enabled care models, digital engagement strategies, and modern decision-support tools to improve affordability, provider engagement, and member experience. Build feasibility business cases and financial models to assess operational readiness and impact when implemented at scale. Incorporate evidence-based medical policies, clinical guidelines, and actionable insights drawn from claims data, clinical outcomes data, utilization trends, quality metrics, member-reported outcomes, digital engagement signals, market intelligence, provider performance patterns, and operational throughput data. Foster stakeholder alignment and cross-functional collaboration to ensure programs are scalable nationwide and sustain continual innovation.

• Data-driven Strategy: Analyze claims utilization and variation, clinical and quality data to identify opportunities for clinical program development and improvement. Use clinical insights to inform program design and measure impact. Collaborate with program managers and analytics teams to model performance expectations and align affordability with operational reality. Analyze appeal trends, overturn rates, peer-to-peer outcomes, and clinical documentation to develop targeted interventions and continuous improvement plans. Work with analytics teams to develop key performance indicators and dashboards to track program performance.

• Stakeholder Collaboration: Seek input from network teams, market teams, and external vendors to develop program models. Build and maintain relationships with executive leadership across internal teams to ensure support and timely feedback, and deliverables are met. Develop and maintain relationships with provider groups and facilities for collaboration on clinical pilots and programs. Collaborate with Regulatory and Compliance Teams to ensure program compliance with state and federal regulatory requirements.

• Communication and Presentation Skills: Speak clearly on complex problems to diverse audiences. Prepare decks and executive summaries for regular updates on clinical program development and performance for business meetings, executive sessions, and clinical program reviews.

• Program Implementation: Use problem-solving skills to support program design and feasibility prior to transition to the Clinical Implementation team. Actively participate in clinical, business, and operational meetings; ensure partners and senior management receive relevant and timely information on program design and scope for the approval process. Provide support to the Clinical Services Implementation team and project managers responsible for moving the program through the clinical implementation lifecycle end-to-end. Participate in multidisciplinary teams to achieve program deliverables; foster collaborative relationships with matrix partners and stakeholders; establish trust and credibility at all levels. Work independently and as a team member.

• Program Oversight and Continuous Improvement: Monitor program performance and KPIs and iterate based on feedback and data. Ensure program compliance with state and federal regulatory requirements; collaborate with Regulatory and Compliance Teams to implement new regulatory requirements. Solve complex problems with broad business impact and translate complex concepts for senior management and other audiences.

Required Qualifications

• Graduate level clinical degree (MSN, DNP, or Master’s in PA Studies)
• 5+ years in a leadership or management role in healthcare
• 5+ years of clinical experience in a cardiovascular specialty with operational accountability
• Experience designing, scaling, or operationalizing enterprise-level clinical programs or value-based care models across multiple markets or lines of business
• Clinical Expertise: Deep understanding of cardiovascular conditions, evidence-based medical policies, and clinical guidelines; ability to apply clinical insights to program design and outcome measurement
• Regulatory Knowledge: Familiarity with health plan regulatory and accreditation requirements
• Technical Skills: Proficiency with MS Word, Excel, and PowerPoint
• Data & Analytics Proficiency: Skilled in analyzing claims, clinical, and quality data to drive insights and identify opportunities for program development; ability to work with healthcare analytics teams to model performance and measure impact
• Leadership Skills: Demonstrated ability to set goals, provide feedback, and conduct evaluations; experience leading and developing small teams of program managers or clinical professionals; ability to guide teams through ambiguity and change; collaborative mindset; self-starter; capable of managing multiple concurrent projects
• Communication and Presentation: Ability to communicate effectively at multiple levels of a large organization and negotiate to achieve mutually beneficial outcomes

Preferred Qualifications

• Master's degree in healthcare administration, public health, or business
• Experience applying AI-enabled analytics, machine learning tools, or large language model (LLM) capabilities in healthcare program design, clinical operations, or outcome measurement
• All 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 salary, benefits include a comprehensive package, incentive programs, equity stock purchase and 401k contribution (eligibility applies). Salary range for this role is $134,600 to $230,800 annually. We comply with all minimum wage laws as applicable.

Application Deadline: This posting will remain open for a minimum of 2 business days or until a sufficient candidate pool is collected. Job posting may close early due to application volume.

UnitedHealth Group is an Equal Employment Opportunity employer. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities. UnitedHealth Group is a drug-free workplace; a drug screen may be required before employment.