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.
Required Qualifications:
- Current, active, unrestricted Registered Nurse (RN) License in the U.S.
- 8+ years of progressive healthcare leadership experience
- 5+ years in ambulatory clinical operations and population health or value-based care program leadership.
- Demonstrated experience leading multidisciplinary teams, building scalable clinical programs, partnering with physicians and payers, and managing performance across quality, utilization, cost, compliance, and patient engagement outcomes
- Able/willing to work Mountain Time Zone business hours regardless of remote base work location
- Must be able/willing to travel approximately 25% of the time as business needs dictate, primarily to the client site in Boulder, CO
Preferred Qualifications:
- Experience with Medicare Advantage, MSSP/ACO models, commercial risk contracts, bundled payments, HEDIS, STAR measures, CMS requirements, and payer-sponsored clinical programs
*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 - $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.
Skills Required
- Current, active, unrestricted Registered Nurse license in the United States
- 8+ years of progressive healthcare leadership experience
- 5+ years of ambulatory clinical operations and population health or value-based care program leadership
- Experience leading multidisciplinary teams and building scalable clinical programs
- Experience partnering with physicians and payers
- Experience managing quality, utilization, cost, compliance, and patient engagement outcomes
- Ability and willingness to work Mountain Time Zone business hours
- Ability and willingness to travel approximately 25% of the time, primarily to a client site in Boulder, Colorado
- Experience with Medicare Advantage, MSSP/ACO models, commercial risk contracts, bundled payments, HEDIS, STAR measures, CMS requirements, and payer-sponsored clinical programs
Optum Compensation & Benefits Highlights
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Parental & Family Support — Paid parental leave (six weeks), paid caregiver leave (up to two weeks), Bright Horizons back-up care, and adoption assistance up to $10,000 are prominently included. Feedback suggests these family supports meaningfully aid work-life balance and are often highlighted as strengths.
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Retirement Support — A 401(k) with company match is available to all employees, including part-time staff, alongside other financial protections like disability and life insurance. Feedback suggests broad access and matching make retirement support a core pillar of the package.
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Equity Value & Accessibility — An Employee Stock Purchase Plan offers discounted company stock, with some roles also eligible for sign-on or performance bonuses. Feedback suggests the ESPP is a standout financial perk that helps employees build ownership over time.
Optum Insights
What We Do
Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.