Remote Director Case Management Jobs in Minnesota

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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.
Primary Responsibilities:

• 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
• Data-driven strategy:
  • 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
• Communication and Presentation Skills
  • Speak clearly on complex problems across a wide range of audiences
  • Prepare decks and executive summaries for regular updates regarding the clinical program development and performance for Joint Operating Committees, Team Leadership and Executive Sessions
• Program Implementation
  • Use problem solving skills and make decisions to support program design and feasibility prior to transition to the Clinical Services Implementation team
  • Actively participate in clinical, business and operational meetings; ensure business partners, stakeholders and senior management are provided relevant and timely information on the clinical program design and scope for the approval process
  • Provide support to the Clinical Services Implementation team and project managers responsible for moving the program initiative through the clinical implementation lifecycle end-to-end
  • Actively participate in multidisciplinary teams to achieve program deliverables; Foster and promote collaborative relationships with matrix partners/stakeholders; Establish trust and credibility at all levels of the organization
  • Work independently and as a team member
• Program oversight and Continuous Improvement
  • Monitor clinical program performance and Key Performance Indicators and iterate based on feedback and data
  • Ensure program compliance with state and federal regulatory requirements; collaborate with Regulatory and Compliance Teams to develop and implement new regulatory and compliance requirements
  • Solve unique and complex problems with broad impact on the business; translate highly complex concepts in ways that can be understood by a variety of audiences, including senior management

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:

• Master's degree, PhD or other advanced degree in a clinical or technology field.
• Deep understanding of health technology's role in care delivery including devices, hardware, and software
• Background in AI, machine learning, and data science, with experience in clinical application
• Familiarity with evidence-based clinical guidelines and policies
• Ability to apply clinical insights to program design and outcome measurement
• Demonstrated ability to design, scale, or operationalize enterprise-level clinical programs or value-based care models across multiple markets or lines of business
• Skilled in analyzing claims, clinical, and quality data to drive new clinical insights and identify opportunities for program development and inform program design
• Ability to work with healthcare analytics teams to model performance expectations and measure clinical and financial impact
• Familiarity with health plan regulatory and accreditation requirements
• Proven ability to lead, coach, and develop small teams of program managers or clinical professionals, fostering a supportive, high-performance culture
• Demonstrated experience setting clear goals, providing regular feedback, and conducting performance evaluations to support career growth and talent retention
• Skilled in guiding teams through ambiguity, change, and complex problem-solving while maintaining clarity, engagement, and accountability
• Solid commitment to collaboration - encouraging cross-functional communication, resolving conflicts constructively, and building trust within and across teams
• Self-starter, initiates work independently
• Ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizations
• Solid negotiation skills: the ability to gain acceptance from others of a plan or idea and achieve a mutually beneficial outcome
• Proficiency with MS-Word, Excel, and PowerPoint

Preferred Qualifications:

• Healthcare experience with operational accountability
• Experience applying AI-enabled analytics, machine learning tools, or large language model (LLM) capabilities in healthcare program design, clinical operations, or outcome measurement
• Experience with FDA and other regulatory body approval processes

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 to $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.