Clinical Automation and Integration Lead - Remote

Optum 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.

This dual-role position blends clinical expertise with strategic project leadership to drive data-informed decision-making and successful implementation of healthcare initiatives. The ideal candidate brings a deep understanding of clinical decision criteria and operations for both inpatient concurrent review and prior authorization. This role will partner closely with the resource responsible for analytical and project management. This role is pivotal in optimizing care delivery, enhancing operational efficiency, and supporting strategic growth across markets.

The Clinical Implementation & Integration Lead serves as a clinical subject matter expert and project leader for new market launches, expansions, and platform integrations. This role ensures clinical requirements are accurately captured, communicated, and executed throughout the project lifecycle. It involves close collaboration with Utilization Management (UM), Case Management (CM), and other clinical teams to ensure readiness and alignment with care delivery standards.

Key responsibilities include translating clinical workflows into system configurations, managing dependencies, and driving go-live success. The role also supports ongoing platform enhancements, clinical data analysis, and strategic planning to improve patient outcomes and operational performance.

You'll enjoy the flexibility to work remotely as you take on some tough challenges.

For all hires within 30 minutes of an office in Minnesota or Washington, D.C., you'll be required to work a minimum of four days per week in-office.

Primary Responsibilities:

• Clinical Implementation & Integration
• Serve as the clinical SME and leadership for a team of resources defining the criteria hierarchy, annotation and UAT for the MAP CAVA project
• Lead cross-functional teams to define and execute clinical requirements for additional new services to be added to the automated decisioning product
• Translate clinical decision trees to be used to teach the tool the required language to translate the information contained in the clinical provided into responses to the criteria questions
• Partner with clinical leadership to ensure readiness across all dependencies and go-live milestones
• Document and communicate clinical business requirements, timelines, and integration plans

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 licensure in the state reside
• Experience translating clinical workflows into system requirements and configurations
• Clinical background in utilization management
• Proven ability to manage multiple priorities in a dynamic healthcare environment
• Proven track record of delivering clinical and data-driven projects with measurable impact

Preferred Qualification:

• Proven excellent communication and stakeholder engagement skills

*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 $71,200 to $127,200 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.