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

UHC Nation Medical Director Clinical Program Governance, Evaluation and Innovation

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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 a team testing innovative solutions and care models in close collaboration with the National CMO of the UCS Clinical Evidence Group. The portfolio of efforts for which the incumbent will provide guide and lead, in collaboration with the National CMO of CEG includes:

Collectively the Evaluation and Innovation efforts generate real world evidence to inform plan and benefits evolution while the governance process ensures continuous 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 anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Governance:
  • Bring a seasoned clinical lens to the review of clinical programs to ensure the clinical model is optimized for impact and experience
  • Review program performance measurement in advance of committee meetings to ensure reports are clear, complete, up to date and transparent These include HCE impact assessments on financial impact
  • 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 Front Door process, the Clinical Discovery Forum and the Clinical Program Review in close collaboration with program owners, health plan leaders and Healthcare economics teams
  • Ensure that the team follows up with clinical program owners and operations teams regularly to ensure CPR recommendations are implemented (or understand why not)
• Clinical Program Evaluation and Innovation
  • Collaboratively lead the Evaluation and Innovation teams to ensure full clinical consideration of solution and care models chosen for trial testing
  • Collaboratively lead the research team in the trial design, analytic planning and interpretation of data and output
  • Lead 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 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:

• Active Board-Certified physician (MD, DO or equivalent)
• Active/unrestricted State(s) Medical Licensure
• Masters level degree (or higher) in statistics, epidemiology, health services research or a related field
• 10+ years of experience as a clinician (MD, DO or equivalent)
• 10+ years of experience in health plan administration, health…