Job Description

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)

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 7 industry leader to do so.

This Associate Director, Health Plan Operations is responsible for Virginia Community Plan Consumer Direction (CD) program for LTSS (long-term services and supports) members and vendor management of the CD vendor/Fiscal/Employer Agent, PPL. The AD HP Ops also serves as the designated leadership Point of Contact (POC) for the CD program with the state partner, DMAS. In this capacity, the AD, HP Ops oversees the CD Vendor 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 contractual measures performance. The AD HP Ops also leads and coordinates participation in CD program and implementation meetings with HP team members, vendors, shared service partners, other MCOs, providers and state partners.

If you are located in Virginia, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

* Manage HP process improvement and implementation projects, including but not limited to, Enhanced Benefits design / implementation, regulatory process changes and implementations, affordability projects, member service and satisfaction process improvement and fee schedule updates
* Act as HP lead for our Business Continuity Planning / Process and partners closely with the C&S Director of Operations Performance in managing non-clinical operational issues, including claims, configuration, encounters, and call centers
* Serve as the secondary POC to the HP Vendor Manager (who oversees Transportation, Vision, Dental Services)

Demonstrated Skills:

* Success in leading cross functional teams to achieve business objectives
* Strong written and verbal communication skills
* Analytical and systems thinking, problem solving and process improvement skills and experience

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:

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

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 similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

* Bachelor's degree in health care or management or equivalent experience
* 3+ years people leadership experience
* Intermediate skills in Excel, PowerPoint, Microsoft Project
* Experience in Medicaid Managed Care for Complex Care populations
* Experience in state regulatory issue resolution and advocacy

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)

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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.

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

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