UnitedHealth Group Associate Director - Solutions and Operations - Telecommute in Eden Prairie, Minnesota
If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life’s best work.(sm)
Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery.
Sr. Capability Manager of Solutions and Operations will be responsible for managing, building, scaling, and supporting solutions and capabilities that generate value and a unified experience to market based customers. This individual will play the role of Risk Adjustment expert and trusted advisor to both internal and external stakeholders and will work closely with Director of Solutions and Operations to drive Risk Adjustment program strategy, innovation and execution. Individual participates in analytical, experimental, investigative and other fact-finding work in support of solution development and may recommend changes to current Risk Adjustment solution development procedures based on market research and new trends.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Analyze and communicate CDO Market characteristics and needs
Collaborate with applicable internal stakeholders to obtain in-depth information/data about Market needs (e.g., Risk Adjustment programs, performance, Risk transfer plans etc.)
Perform / leverage research to help establish new markets and risk transfer market needs and trends and provide actionable insights
Develop understanding of CDO / market characteristics, needs, and problems
Strategic thinking and analysis around financial and operational performance, opportunities for improvement
Demonstrate understanding of the comparative landscape (e.g., strengths, weaknesses, Risk Adjustment performance gaps, program portfolios)
Define/Manage Solution Strategies and Plans
Perform appropriate research / analyses to help drive Risk Adjustment solution strategies
Develop functional / business specifications to drive solution planning and development
Define applicable quality measures to evaluate Solution performance
Assess and propose alternative solutions to support market strategies
Define how we measure solution value and conduct analysis (e.g., ROI and value methodology)
Identifies and leverages solutions/tools/processes deployed in individual markets that can be utilized at scale across the enterprise
Manage / Support / Update Products and Programs
Monitor and evaluate solution performance on an ongoing basis, using applicable Risk Adjustment performance metrics, operational metrics, and recommend appropriate action
Provide consulting on proposed solution customizations, based on specific CDO or market requirements and evolving business needs
Design and manage development of dashboards relating to Risk Adjustment
Develop / Manage Client Relationships
Establish productive relationships and clear lines of communications with Market Relations, relevant CDO stakeholders and decision-makers
Research, understand and anticipate the CDOs current and future risk Adjustment needs, challenges and strategies (e.g., leveraging industry knowledge and experience)
Cultivate the CDOs perception of Clinical Performance as a trusted partner and strategic advisor
Drive high levels of CDO satisfaction by focusing efforts on results that meet or exceed the CDOs expectations
Maintain ongoing contact with Market Relations team and CDOs to identify and address emerging issues / concerns
Demonstrate Market and Industry Knowledge
Stay current on important issues in the healthcare industry
Demonstrate strong knowledge of CMS Risk Adjustment and ICD-10 coding requirements and regulations. Stay abreast of changes/updates in relevant policies, procedures and regulations
Leverage knowledge of the market and industry to drive service excellence and Risk Adjustment performance
Demonstrate understanding of the market-based nuances
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.
Bachelor’s degree in Engineering, Math, Statistics or Business
3+ years of Risk Adjustment experience
2+ years of progressive leadership experience including leading operations, and/or business process improvement initiatives
Ability to work in a matrix organization
Ability to influence with and without direct management / authority
Deep familiarity with CMS data and risk adjustment processes including MMR, MOR, and EDS data
Understanding and experience using analytical concepts and statistical techniques analyzing data, drawing conclusions, and developing actionable recommendations for business units
Solid SQL skills, ability to perform effective querying involving multiple tables and subqueries. Ability to work in a matrix organization
Technical competency with experience creating and applying data analytics to solve business problems
Superior verbal and written communication skills
Superior customer / consultant relationship management and collaboration skills
If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
Proficient in Business Intelligence tools such as Power BI, Tableau, etc.
Knowledge of Software Development Life Cycle methodologies. Working knowledge of data mining principles: predictive analytics, mapping, collecting data from multiple data systems on premises and cloud-based data sources
Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)
Colorado Residents Only: The salary range for Colorado residents is $94,500 to $171,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter policy.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Associate Director, Solutions and Operations, Telecommute, Remote, Work from Home
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