Clinical Program Director - Laboratory and Pathology - Remote

At United Healthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while
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The Clinical Program Director, Pathology & Laboratory provides strategic leadership for the development, implementation, and oversight of clinical programs designed to optimize laboratory and genomic testing utilization, affordability, quality, and outcomes. This role builds collaborative relationships with laboratories, specialty societies, provider organizations, and internal partners while working closely with Payment Integrity and network teams to address complex billing, coding, reimbursement, and claims issues.

The Director leads cross-functional teams of program managers, analysts, technology partners, and business leaders through the full program lifecycle, from opportunity assessment and business-case development to implementation and performance measurement. Through solid clinical, financial, and operational expertise, this leader ensures programs align with evidence-based guidelines, organizational objectives, and financial goals while effectively managing multiple priorities and driving results across the enterprise.

You’ll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges.

• Utilization management, care management, value-based care programs and protocols to optimize total cost trend and utilization across clinical laboratory testing, including molecular diagnostics
• Manage resources including flexible and agile pool of Program Managers, assign projects and efficiently move it through the project lifecycle from end-to-end
• Oversee effective implementation of programs that have a variety of approaches and requirements in partnership with internal and external partners
• Build and develop relationships across teams to ensure effective support and feedback loops and that deliverables are met
• Ensure Program Managers complete implementation activities needed to efficiently move programs through the project lifecycle
• Use problem solving skills and make decisions to move implementation forward
• Expert in reviewing, evaluating and documenting business requirements and facilitating discussions with operational and technology partners, based upon business requirements for IT-related projects
• Ensure compliance with financial goals

• Develop and maintain solid relationships with executive leadership of internal teams and external vendors
• Partner with executive leadership from all LOBs to achieve mutual success on achieving/exceeding targets
• Develop and maintain solid relationships with provider groups/facilities for collaboration on clinical pilots and programs
• Oversee frequent cadence of communications to allow deeper understanding of shared objectives, emerging issues internal and external

• Lead efforts to understand and solve for the complexities of coding and reimbursing laboratory services
• Ensure alignment with published guidelines and Society recommendations
• Use problem solving skills and negotiation skills to resolve discrepancies
• Represent UHC Value Creation Laboratory team in internal and external discussions

• Develop cost benefit analyses and business cases for clinical programs
• Develop and analyze Key Performance Indicators for clinical…