Director of Clinical Optimization - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Director of Clinical Optimization (DCO) is a highly visible role which is responsible for ensuring that all customer commitments are met, including clinical-based and operations targets in a fast paced, multi-stakeholder environment. This Director has significant customer interface and acts as the liaison between account management and operations. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Single point of contact for UnitedHealth Care Strategic Client Executives and Optum Strategic Account Executives for a portfolio of strategic National and Key Accounts Role serves as the program director for clients including managing population of over 360K members and 50+ clients with specific focus on partnership with the consultant (Mercer) including intense support, including HCC reviews and onsite strategy meetings Accountable for the end-to-end operational performance against Customer deliverables within Population Health Service delivery Manages Customer commitments and expectations jointly with Account Management Team Ensures scalability and sustainability of Customer specific operational processes delivering against Customer commitments Drives Customer performance against quality metrics; communicates customer status and remediation action plans Proactively identifies and mitigates potential service gaps and customer specific quality opportunities ensuring a timely resolution. Monitors the performance of Optum products to ensure program metrics are meeting internal operating goals Track and manage to client-specific clinical performance guarantees (CPG) and claims trend guarantees (CTG) Contribute to client-facing presentations of program performance results in health plan reviews and Customer partnership meetings Responsible for researching and resolving clinically related member escalations Participate in Customer specific implementation meetings (internal & external), including client transitions as necessary; conducts post-implementation system audits Partners with clinical team & leadership to identify, implement and monitor outcome- based strategies tailored to Customer-specific culture and membership Collaborates with internal and external programs to ensure strong integration with clinical programs and efficient vendor referral processes Proposes, implements & monitors customer-specific service delivery pilots to address efficiency opportunities and process gaps Develops and leads execution of continuous improvement initiatives to ensure exceptional member experience and Customer satisfaction Engage in Customer audit preparation meetings, including initial scope discovery meetings; partners with the Audit Team, Operations and Product to prepare pertinent materials and slides Manage post Customer audit action plans to completion through accountable owners Contributes to & participates in High-Cost Claimants reviews if service purchased by customer and Exception is approved with defined parameters Partner with internal resources across operations, business intelligence and product to enhance cross-program coordination Responsible for presenting Customer Performance reporting to internal audiences Works with Product owners and Finance to ensure profitability of the model Participate in finalist meetings and contribute to renewal RFPs demonstrating