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Job Description - Clinical Program Director of Health Technology Innovation - Remote (2352047)

Clinical Program Director of Health Technology Innovation - Remote - 2352047

At UnitedHealthcare, 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 to start Caring. Connecting. Growing together.

The Clinical Program Director of Health Technology Innovation is responsible for ideating, designing, and evaluating digital and device related therapeutic strategies for metabolic, behavioral, and functional care pathways. The Director manages a small team of program managers and works with healthcare analytics, clinical implementation, technology, and medical management teams to develop and monitor Clinical Programs at United Healthcare. The Director leads the United Healthcare operating model for horizon scanning, assessment, and benefit strategy for emerging medical technologies (devices and diagnostics), software as a medical device (SaMD), remote patient monitoring, and digital therapeutics. The role orchestrates cross functional reviews and recommendations for coverage and management —e.g., prior authorization (PA), reimbursement policy, medical benefit placement, digital formulary inclusion, value based or network/contracting strategies—to drive safe, equitable, clinically effective, and cost responsible adoption. The Director works closely with the Medical Policy Team for digital formulary recommendations and the Clinical Evidence Group for vetting of digital pilots and vendors.

AI enabled clinical products and programs will be in scope as will be the evaluation of technology application in remote and asynchronous care models including wellness and lifestyle medicine related initiatives. The Director reports to the National Medical Director of Behavioral Health at UnitedHealthcare Clinical Services. The ideal candidate combines clinical expertise, strategic thinking, a flexible mindset, and program development skills to create impactful solutions for members and providers. This role aims to improve total cost of care, health outcomes, and member and provider experience.

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

• Clinical Program Ideation and Design:
  • Use clinical, claims and quality data and knowledge of emerging trends in the specialty care industry to identify key opportunities to design large-scale, enterprise-level clinical management programs that drive meaningful affordability, quality, and experience outcomes across diverse populations and lines of business
  • Leverage emerging technologies, including advanced analytics, artificial intelligence (AI), and large language models (LLMs) to enhance program design efficiency, automate insights, and identify innovative clinical pathways that support proactive and personalized care
  • Use clinical, claims, and quality data to identify high-impact cost drivers, utilization trends, and care variation at scale
  • Conceptualize new clinical programs that incorporate technology-enabled care models, digital engagement strategies, and modern decision-support tools for pre and post service medical management and value-based care
  • Build feasibility business cases and financial models to assess operational readiness and impact when implemented at scale
  • Incorporate evidence‑based medical policies, clinical guidelines, and a broad spectrum of actionable insights — including claims data, clinical outcomes data, utilization trends, quality metrics, member‑reported outcomes, digital engagement signals, market intelligence, provider performance patterns, and operational throughput data — gathered across markets, providers, and enterprise data sources
  • Foster stakeholder alignment and cross-functional collaboration to ensure programs are designed to support national scalability, operational sustainability, and continual innovation
• Analyze claims utilization and variation, clinical, and quality data to identify opportunities for clinical program development and improvement
• Use clinical insights and knowledge to inform program design and measure impact
• Work with program managers and analytics teams to accurately model performance expectations to correlate the expected affordability to the operational reality of the program
• Analyze appeal trends, overturn rates, peer-to-peer outcomes, and clinical documentation to develop targeted interventions, provider feedback loops, and continuous improvement plans
• Collaborate with analytics teams to develop Key Performance Indicators and to build dashboards tracking program performance
• Stakeholder Collaboration:
  • Seek input from network teams, market teams and external vendors to develop program models
  • Build and maintain strong relationships with executive leadership across internal teams to ensure effective support and feedback loops and that deliverables are met
  • Develop and maintain strong relationships with provider groups/facilities for collaboration on clinical pilots and programs
  • Collaborate with Regulatory and Compliance Teams to ensure program compliance with state and federal regulatory requirements