Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Director of Population Health Care Transformation provides executive leadership for all ambulatory clinical service lines, including care management, transitional care management, chronic disease management, pharmacy support, and value-based care programs. Responsible for strategic planning, operational performance, quality outcomes, regulatory compliance, and financial performance of ambulatory clinical programs while partnering with physicians, operations, and payer organizations to achieve organizational goals. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Lead Ambulatory Care & Clinical Services • Direct oversight of ambulatory care management, transitional care management, pharmacy support, and future ambulatory clinical programs • Supervise department managers and ensure efficient daily operations, staffing, productivity, and performance Population Health & Value-Based Care Strategy • Develop and execute ambulatory population health strategies supporting Medicare Advantage, MSSP, commercial risk contracts, bundled payment models, and other value-based initiatives • Ensure clinical programs are aligned with contractual performance measures and organizational priorities Collaboration • Oversee cross-organization and cross-team collaboration with the client and internal partners to align priorities, coordinate execution, remove barriers, and ensure shared accountability for clinical, operational, and value-based care outcomes Clinical Program Development & Transformation • Design, implement, and optimize ambulatory clinical programs and workflows • Lead implementation of new clinical initiatives, technology solutions, and evidence-based care models • Drive continuous improvement across ambulatory services Payer & Physician Partnership • Serve as the clinical operational lead for payer-sponsored programs • Partner with physician leadership, finance, contracting, quality, and ambulatory operations to maximize clinical and financial performance under value-based contracts Quality, Outcomes & Financial Performance • Accountable for performance across: • Readmissions • ED utilization • HEDIS and STAR measures • Total cost of care • Medication adherence • Care management outcomes • Patient engagement • Develop action plans to improve organizational performance Leadership & Team Development • Provide leadership, mentoring, and accountability for managers and clinical leaders • Build scalable ambulatory programs while fostering collaboration and professional development • Regulatory & Operational Excellence • Ensure compliance with CMS requirements, accreditation standards, payer expectations, and organizational policies • Establish standardized workflows, documentation practices, and performance metrics across ambulatory services 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.
Optum Home & Community Care is part of UnitedHealth Group and provides telephonic case management services to help members navigate the health care system and access support services. As an RN Case Manager, you would assess members' health status, identify gaps in treatment plans, establish care goals, coordinate with multidisciplinary teams including mental health clinicians, provide patient education and coaching, make referrals to community resources, and facilitate transitions between care settings—primarily through phone calls in a high-volume customer service environment.
