Clinical Program Consultant - Waltham, MA

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

In the Community Services Manager role, you will lead a team of professionals and paraprofessionals providing care coordination. You will work with contracted Community Based Organizations providing oversight and management to a diversified group of Long Term Supports Coordinators (LTSCs). You will manage a team of Community Health Workers, performance management, process improvement, and standardized execution of clinical decision processes, and implementation of new program initiatives. Complying with contractual requirements and ensuring member needs are met.

One Care is a fully integrated Medicare and Medicaid product that serves individuals between the ages of 21 and 64 who have physical and intellectual disabilities.

Primary Responsibilities:

• Selects, manages, develops, mentors and supports staff in designated department or region
• Oversee and act as a liaison with our contracted LTSCs
• Develops clear goals and objectives for performance management and effectively communicates expectations and holds the team accountable for results
• In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
• Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements
• Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
• Acts as regional interface with other departments to coordinate workflow processes and implementation plans
• Demonstrates a positive leadership shadow by shaping positive behaviors, influencing our values, and creating a healthy, high-performance environment

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:

• Undergraduate degree or equivalent experience
• 5 years of experience working within the community health setting in a health care role
• Intermediate level of experience with MS Office (Excel, Word, MS Teams, etc)
• Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance

Preferred Qualifications:

• 3 years of leadership experience 
• Experience coaching or mentoring staff
• Experience with Community partners
• Case Management experience
• Background in managed care
• Knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid)
• Curious, adaptable, flexible, and able to work with changing direction and priorities
• Proven interpersonal, communication and relationship building skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

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.