Remote Clinical Process Modernization Consultant

UnitedHealth Group; Minnetonka (MN); Remote; USD 92,000 - 131,000; Full time

Job summary

UnitedHealth Group is seeking a Clinical Program Consultant - Process Modernization to lead multi-disciplinary workflow modernization across UCS Operations & Implementation. You will translate complex clinical and operational needs into executable plans, drive requirements, and coordinate cross-functional teams to deliver measurable improvements.

This role is remote within the U.S. with strong growth opportunities.

Qualifications

• Experience facilitating cross-functional discovery or working sessions and translating complex operational needs into clear requirements, decisions, and executable workplans.
• Experience managing complex projects or programs within healthcare, clinical operations, technology, business operations, or another highly matrixed environment.
• Demonstrated experience developing project plans and managing milestones, dependencies, risks, issues, decisions, implementation readiness, and executive status reporting.
• Proficiency using AI tools to support project delivery, workflow analysis, requirements development, documentation, and business-process improvement.
• Demonstrated ability to coordinate clinical, operational, business, and technical stakeholders where accountability and decision-making are distributed.
• Demonstrated solid analytical, problem-solving, written, and verbal communication skills.
• Demonstrated ability to manage multiple interconnected initiatives and competing priorities.

Responsibilities

• Lead assigned workflow improvement and modernization initiatives from discovery through implementation, stabilization, and transition to operational ownership.
• Develop and maintain integrated project plans covering scope, milestones, deliverables, owners, dependencies, decisions, risks, testing, and implementation activities.
• Facilitate workflow discovery with business and clinical stakeholders to identify pain points, manual steps, duplicate activities, fragmented handoffs, control gaps, and improvement opportunities.
• Translate workflow findings and strategic priorities into clear requirements, future-state processes, decision points, exception paths, executable workplans, and measurable outcomes.
• Coordinate cross-functional delivery across clinical, operations, policy, benefits, coding, configuration, technology, regulatory, compliance, and line-of-business partners.
• Establish project cadence, working sessions, status reporting, RAID management, decision tracking, and escalation processes; proactively address critical-path issues affecting scope, schedule, or readiness.
• Coordinate requirements validation, testing, change readiness, communications, implementation planning, and post-launch issue resolution.
• Provide concise leadership reporting on project progress, milestones, risks, dependencies, decisions, readiness, and outcomes.
• Support modernization efforts involving prior authorization intake and configuration, claims edit configuration, manual workflow digitization, DTQ review automation, clinical coding automation, clinical pre-determination, and competitor policy monitoring.

Skills

Cross-functional discovery

Project management

Stakeholder coordination

Analytical thinking

Communication skills

AI tools for delivery

Education

PMP/CAPM/Lean Six Sigma

Tools

AI analytics tools

Job description

UnitedHealth Group is seeking a Clinical Program Consultant - Process Modernization to lead multi-disciplinary workflow modernization across UCS Operations & Implementation. You will translate complex clinical and operational needs into executable plans, drive requirements, and coordinate cross-functional teams to deliver measurable improvements.

This role is remote within the U.S. with strong growth opportunities.