Director Clinical Guidance and Effectiveness - Remote

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

In the Optum Health Clinical Excellence organization, you will drive strategic decision-making and support the clinical strategy. You will facilitate cross-functional execution within Optum Health and assist in key business processes, establishing a unified language and roadmap.

Our mission is to define and achieve the clinical true north for Optum Health, streamline the delivery system, and empower our system partners to deliver differentiated outcomes.

Our Vision is that our patients live longer with better quality of life and our clinicians are empowered to deliver the best outcomes and experiences for those patients.

This role involves using clinical expertise and business acumen to guide Optum Health leaders and teams on clinical domains, projects, programs, and initiatives. It aims to gain consensus to identify optimal business solutions for improving clinical and operational processes. Responsibilities include providing directives to identify best practices, drive standardization and optimization, and enhance performance or financial outcomes. Knowledge of Optum Health's structure is crucial for proactively collaborating and influencing cross-organizational clinical program activities. This role also requires building relationships with clinical, product, and business teams to shape the future state of the business.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Schedule is Monday through Friday within the hours of 7AM-6PM

Primary Responsibilities:

• Clinical Strategy & Priority Setting
  • Lead the scoping and prioritization of national clinical guidance initiatives in collaboration with Risk, NOCMO, AI teams, Technology, and other enterprise partners
  • Establish a unified clinical roadmap aligned to evidence-based standards, regulatory requirements, and organizational strategy
  • Partner with clinical leadership to ensure guidance is current, clinically sound, and scalable
• Cross-Functional Partnership & Execution
  • Collaborate with value-based care, clinical models of care, optimal care, and high-value care teams to ensure guidance meets business and clinical needs
  • Facilitate cross-functional forums to drive alignment, resolve concerns, and build consensus
  • Influence without authority in a highly matrixed environment
• Operational Leadership
  • Provide leadership and direction to the Clinical Guidance & Effectiveness team
  • Oversee daily operations including project management, analytics, prioritization, workflow optimization, and reporting
  • Implement and monitor efficient, repeatable processes for guidance development and maintenance
• Clinical Guidance Development
  • Develop and execute strategies for the creation, implementation, and lifecycle management of clinical guidelines and supporting materials
  • Standardize best practices while identifying opportunities for innovation and process improvement
  • Ensure guideline development meets quality, timeliness, and compliance standards
  • Problem Solving & Decision-Making
  • Direct resolution of complex business and clinical challenges related to guidance development
  • Navigate stakeholder conflicts, resource constraints, and regulatory considerations
  • Provide strategic, operational, and administrative recommendations in response to emerging conditions
• Performance Monitoring & Continuous Improvement
  • Track progress against timelines, KPIs, OKRs and performance metrics
  • Collect and analyze stakeholder feedback to assess effectiveness and impact
  • Drive continuous improvement in quality, operational efficiency, and financial performance
• Stakeholder & External Relationships
  • Build strong internal partnerships across clinical, operational, product, and technology teams
  • Maintain relationships with external entities including medical societies, academic research centers, and regulatory organizations
  • Communicate transparently and regularly on progress, outcomes, and next steps
• Compliance & Governance
  • Ensure adherence to organizational policies, procedures, and regulatory requirements
  • Stay current on compliance changes affecting clinical guideline creation
  • Educate and enable teams on compliance expectations and standards

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:

• 5+ years of experience in the managed care or health insurance industry (government programs, network management, legal, or compliance)
• 5+ years of experience in data analysis, process documentation, and process improvement
• 5+ years of project management experience
• Experience leading teams through organizational change and transformation
• Demonstrated ability to influence and motivate stakeholders at all organizational levels
• Proven success operating in complex, matrixed environments with strong systems-thinking capability
• Proven solid strategic thinking with a consistent record of execution and results accomplishment
• Proven advanced critical thinking, analytical, and problem-solving skills
• Proven excellent written and verbal communication skills
• Proven ability to manage multiple competing priorities with agility
• Proven solid growth mindset and demonstrated ability to leverage innovation

Preferred Qualifications:

• PMP or CPHQ certification
• 3+ years of experience in clinical policy or clinical guideline development

*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.