Director Business Process - Remote - 2285448

UnitedHealth Group; San Antonio (TX); Remote; Confidential; Full time

Job summary

An innovative organization is seeking a Director of Managed Care Programs to lead initiatives that enhance healthcare delivery through technology. This role offers the flexibility to work remotely while managing provider incentive programs, ensuring compliance with performance metrics, and fostering relationships with healthcare professionals. The ideal candidate will have extensive experience in managed care and a strong understanding of HEDIS and STARs metrics. Join a forward-thinking team committed to advancing health equity and improving community health outcomes.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contributions

Qualifications

• 15+ years of management-level experience in managed care.
• Proven ability to establish effective relationships with healthcare professionals.

Responsibilities

• Manage provider incentive programs to meet quality standards.
• Oversee all aspects of program management and track effectiveness.

Skills

Management-level experience in managed care

Knowledge of HEDIS and STARs Performance

Excellent communication skills

Fiscal management techniques

Human resource management techniques

Job description

Job Description: Director of Managed Care Programs

Optum, a global organization, delivers care aided by technology to help millions live healthier lives. Join our team to improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need. We foster a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Make an impact on communities and help advance health equity worldwide. Join us to start Caring. Connecting. Growing together.

Enjoy the flexibility to work remotely * from anywhere within the U.S. while tackling challenging projects.

We reward and recognize performance in a challenging environment that provides clear success criteria and development opportunities for future roles.

Responsibilities:

1. Manage provider incentive programs: Work with STARs and HEDIS performance metrics to ensure provider networks engage in competence and practice screenings, and care management to meet quality standards. Develop programs that incentivize providers to implement workflow changes, including bonus programs similar to CMS STAR ratings at the provider level.
2. Knowledge of HEDIS and STARs Performance: Understand and translate these metrics into effective incentive programs.
3. Program Management: Oversee all aspects, including creating reporting tools, presenting updates, tracking effectiveness, and monitoring financials.
4. Return on Investment: Ensure investments in incentive programs yield positive returns.

Required Qualifications:

• 15+ years of management-level experience in managed care, including 5+ years at the Director level or above.
• Knowledge of business environment and requirements, including strategy changes and emerging needs.
• Understanding of federal and state laws, NCQA regulations related to managed care, and medical management.
• Fiscal management and human resource management techniques.
• Proven ability to establish effective relationships with employees, healthcare professionals, physicians, senior management, and the public.
• Excellent verbal, written communication, presentation, and facilitation skills.
• Willingness to travel as needed.

*All remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.

The salary range is $124,500 to $239,400 annually, based on experience, location, and other factors. Benefits include comprehensive packages, incentive and recognition programs, equity stock purchase, and 401k contributions, subject to eligibility.

Application Deadline: Minimum of 2 business days or until a sufficient candidate pool is reached. The posting may close early based on applicant volume.

UnitedHealth Group is committed to health equity and diversity, aiming to mitigate barriers to good health and address disparities. We are an Equal Employment Opportunity employer and a drug-free workplace requiring a pre-employment drug test.