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.
The Director of Affordability and Solutions (DAS) is a highly visible role which is responsible for ensuring that all customer commitments are met, including clinical-based and operations targets in a fast paced, multi-stakeholder environment. This Director has significant customer interface and acts as the liaison between account management and operations.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Single point of contact for UnitedHealth Care Strategic Client Executives and Optum Strategic Account Executives for a portfolio of strategic National and Key Accounts
End-to-end operational performance against Customer deliverables within Population Health Service delivery
Manages Customer commitments and expectations jointly with Account Management Team
Ensures scalability and sustainability of Customer specific operational processes delivering against Customer commitments
Drives Customer performance against quality metrics; communicates customer status and remediation action plans
Proactively identifies and mitigates potential service gaps and customer specific quality opportunities ensuring a timely resolution
Monitors the performance of Optum products to ensure program metrics are meeting internal operating goals
Track and manage to client-specific clinical performance guarantees (CPG) and claims trend guarantees (CTG)
Contribute to client-facing presentations of program performance results in health plan reviews and Customer partnership meetings
Researching and resolving clinically related member escalations
Participate in Customer specific implementation meetings (internal & external), including client transitions as necessary; conducts post-implementation system audits
Partners with clinical team & leadership to identify, implement and monitor outcome- based strategies tailored to Customer-specific culture and membership
Collaborates with internal and external programs to ensure solid integration with clinical programs and efficient vendor referral processes
Proposes, implements & monitors customer-specific service delivery pilots to address efficiency opportunities and process gaps
Develops and leads execution of continuous improvement initiatives to ensure exceptional member experience and Customer satisfaction
Engage in Customer audit preparation meetings, including initial scope discovery meetings; partners with the Audit Team, Operations and Product to prepare pertinent materials and slides
Manage post Customer audit action plans to completion through accountable owners
Contributes to & participates in High-Cost Claimants reviews if service purchased by customer and Exception is approved with defined parameters
Partner with internal resources across operations, business intelligence and product to enhance cross-program coordination
Presenting Customer Performance reporting to internal audiences
Works with Product owners and Finance to ensure profitability of the model
Participate in finalist meetings and contribute to renewal RFPs demonstrating expertise and knowledge of their membership
Contributes to and participates in 1) AMT & Partnership meetings, as defined by purchased product, 2) QBRs to provide Customer-specific commentary on remediation plans, 3) external Customer & vendor meetings
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:
Registered Nurse or other healthcare experience
5+ years of managed care clinical operations or account management
2+ years of customer presentation experience
Program management and product management experience
Proven ability to understand customer data and make recommendations to operations / clients based on analytics
Proven excellent verbal and written communication skills
Proven solid relationship management skills: internal (staff, matrixed resources) and external (client, carrier, consultants & vendor)
Proven operational End to End thinker: broad program and delivery modality knowledge
Demonstrated strength in negotiation and gaining consensus across a multidisciplinary team (internal & external partners) to include Clinical Consultants, product, and account management
Demonstrated strategic operations leader: able to make decisions and drive execution
Preferred Qualification:
5+ years call center operations experience
*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 $110,200 to $188,800 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.
UnitedHealth Group
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