20 days old

Associate Director, Health Plan Ops, Consumer Direction - Telecommute VA - 916070

Richmond, VA 23219 Work Remotely
  • Job Code
    916070

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

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Transforming health care for everyone takes a huge effort. But we never said major impact was easy. At UnitedHealthcare, we are working to create a system that is connected, aligned and more affordable for all involved. One that delivers high quality care, responsive to the needs of each person and the communities in which they live. And as part of the UnitedHealth Group family of businesses, we have the support and resources of a Fortune 6 industry leader to do so.

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This Associate Director, Health Plan Operations is responsible for Virginia Community Plan Consumer Direction (CD) program for Medicaid members, and vendor management and oversight of the CD vendor/Fiscal/Employer Agent. The AD HP Ops serves as the designated leadership Point of Contact (POC) for the CD program with our state regulator. The AD, Health Plan Operations also works with the C&S Director of Operations Performance in managing non-clinical operational issues and leads process improvement and implementation projects involving the health plan and shared service partners.

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Primary Responsibilities:

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  • Oversight of CD Vendor performance, including contracting, change management and implementation, Joint Operating Committees (JOCs), financial reconciliation, regular and ad hoc reporting, data exchanges, complaint resolution, member satisfaction and vendor accountability for regulatory compliance and performance
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  • Lead and coordinate participation in CD program and implementation meetings with HP clinical team members, vendors, shared service partners, other MCOs, providers and state partners
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  • Manage HP process improvement and implementation projects, including Enhanced Benefits design/implementation, regulatory process changes and implementations, affordability projects, member service and satisfaction process improvement and fee schedule updates
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  • Partner with the C&S Director of Operations Performance in managing non-clinical operational issues, including claims, configuration, encounters, and call centers
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  • Lead HP Business Continuity Planning process and response
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  • Serve as the secondary POC for HP Vendor Management (including Transportation, Vision, Dental Services)
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Demonstrated Skills:

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  • Success in leading cross functional teams to achieve business objectives
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  • Strong written and verbal communication skills
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  • Analytical and systems thinking, organized problem solving and process improvement skills and experience
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  • Proven skills in Word, Excel, PowerPoint, Microsoft Project
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Required Qualifications:

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  • 5+ years experience in health care non-clinical and clinical operations (i.e., claims, call center, encounters, care management processes and systems, etc.)
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  • 3+ years vendor management experience, including contracting/negotiation and vendor oversight
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  • 5+ years project management skills, including ability to build and manage an implementation, problem solving or process improvement project plan
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  • 5+ years professional presentation and engagement skills with enterprise executives, state regulators and external vendors
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  • Live within commutable distance to Richmond, VA
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  • Be able to travel to Richmond, VA monthly as needed to meet with health plan team, regulator and business partners
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Preferred Qualifications:

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  • Bachelors degree in health care or management or equivalent experience
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  • 3+ years people leadership experience
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  • Experience in Medicaid Managed Care with complex care populations
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  • Experience in state regulatory issue resolution and advocacy
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Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

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All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Associate Director, Health Plan Operations, Consumer Direction, C&S, Community & State, UHC, UnitedHealth Care, UHG, UnitedHealth Group, Telecommute, Telecommuting, Telecommuter, Remote, Work from Home, Richmond, VA, Virginia

Categories

Posted: 2021-03-23 Expires: 2021-04-30

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Associate Director, Health Plan Ops, Consumer Direction - Telecommute VA - 916070

UnitedHealth Group
Richmond, VA 23219

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