Director Business Process - Remote

Optum; San Antonio (TX); Remote; USD 124,000 - 240,000; Full time

Job summary

An established industry player is seeking a seasoned professional to lead provider incentive programs, ensuring quality standards in managed care. This role offers the flexibility of remote work within the U.S., allowing you to tackle significant challenges while making a positive impact on health outcomes. With a focus on diversity and inclusion, the organization provides comprehensive benefits and opportunities for career growth. If you are passionate about advancing health equity and have extensive experience in managed care, this position is an exciting opportunity for you.

Benefits

Comprehensive benefits packages

Incentive programs

Equity stock purchase

401k contributions

Qualifications

• 15+ years of management-level experience in managed care.
• Excellent communication, presentation, and facilitation skills.

Responsibilities

• Manage provider incentive programs and ensure quality standards.
• Translate HEDIS and STARs metrics into effective incentive programs.

Skills

Management-level experience in managed care

Knowledge of federal and state laws

Fiscal and human resource management

Communication and presentation skills

Job description

2 days ago Be among the first 25 applicants

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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

You’ll be rewarded and recognized for your performance in an environment that will challenge you, provide clear direction on success, and offer development opportunities for other roles you may be interested in.

Responsibilities

• Manage provider incentive programs, working with STARs and HEDIS performance metrics to ensure provider networks engage in competence and practice screenings, as well as care management to meet quality standards.
• Develop programs that offer bonus dollars, similar to CMS STAR ratings, but at the provider level.
• Translate HEDIS and STARs metrics into effective incentive programs.
• Manage all aspects of incentive programs, including creating reporting tools, presenting updates, tracking effectiveness, and monitoring financials.
• Ensure investments in these programs yield positive returns.

Required Qualifications

• 15+ years of management-level experience in managed care, including five or more years at the Director level or above.
• Knowledge of federal and state laws, NCQA regulations related to managed care, and Medical Management.
• Experience in fiscal and human resource management techniques.
• Proven ability to establish effective working relationships with healthcare professionals, physicians, and management.
• Excellent communication, presentation, and facilitation skills.
• Willingness to travel as needed.
• Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.

The salary range is $124,500 to $239,400 annually, based on full-time employment and various factors such as location, experience, and certifications. Benefits include comprehensive packages, incentive programs, equity stock purchase, and 401k contributions, subject to eligibility.

Application deadline: Posted for at least 2 business days or until a sufficient candidate pool is reached. Job posting may end early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and improve the health system for everyone. We are committed to addressing health disparities and promoting health equity, especially for marginalized groups.

UnitedHealth Group is an Equal Employment Opportunity employer and a drug-free workplace. Candidates must pass a drug test before employment.