Job Description

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

On the one hand, no industry is moving faster than health care. On the other, no organization is better positioned to lead health care forward than Optum and UnitedHealth Group. That's what makes this opportunity so inviting. We have hundreds of business verticals across our matrixed organizations that are bringing thousands of new ideas, services and products to the marketplace every year. Our goal is simple. Use data and technology to help drive change and make the health care system work better for everyone. When you join us as a Pharmacy Programs Manager, you'll be engaged in a complex business model that is highly adaptable to build solutions that meet their customer needs in a competitive and effective way. If you're out to do more, this is the place to be.

Responsible for assisting with strategy, analysis and execution of initiatives, programs and solutions with care delivery organizations. Apply advanced understanding of healthcare systems, data analytics, finance acumen, care delivery organization operations, practice operations, revenue cycle management, health plan operations and medical benefits to identify opportunities for affordability programs. Serve as subject matter expert, e.g. clinical knowledge, project scope definition, risk identification, resource allocation, facilitation, analytics, and finance. Make presentations to management on project updates, project cycle, and expected results. Collaborate with stakeholders across UHC, Optum, Care Delivery Organizations, and other stakeholders to ensure projects are aligned with core strategies and goals, implemented and launched on time and in scope. Participate in annual business planning and end-to-end designs of programs and strategies.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

* Develops functional, market level, and/or site strategy, plans, production and/or organizational priorities
* Ensure alignment and understanding of program / project scope and objectives with Clinical Performance and care delivery organization's (CDOs) goals.
* Predicts emerging customer needs and develops innovative solutions to meet them
* Partner with various business units, leadership, and CDOs to identify / define performance planning / measures, programs, initiatives, based on emerging industry trends and growth opportunities
* Oversee and instruct functionally diverse teams in order to achieve desired end-results on complex problems regarding projects
* Lead and guide functional and segment teams through project implementations with competing agendas and priorities
* Identifies and resolves technical, operational and organizational problems outside of own team
* Develop appealing data visualizations leveraging multiple internal and external data sources (quantitative and qualitative), and drawing insightful conclusions for decisions makers
* Solve unique and complex problems with broad impact on the business
* Provide subject matter expertise and operational support to internal business partners
* Coach, mentor and provide feedback to others
* Maintain project and process knowledge bank to support best practice identification and implementation
* Collaborate cross departmentally to manage risk forecasting / mitigation, project progress and issue resolution efforts
* Act as a liaison between internal and external teams to help steer work stream communications to ensure response integrity
* Influence senior leadership to adopt new ideas, products, and/or approaches that may have segment-wide impact
* Perform all other related duties as assigned

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:

* Active BSN, RN license
* 7+ years of experience with provider practice or hospital operations, contracting, pricing, reimbursement (physicians, hospitals, pharmacies / HIT, ancillary groups & facilities, etc.), revenue cycle, network management with accountability for business results
* 5+ years of experience with clinical quality, process improvement, education & training, and value-based care strategy
* 5+ years of experience with data analysis, financial modeling, alternative payment methodologies
* 3+ years of experience working with Medicare reimbursement methodologies (in-depth knowledge), i.e. Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, HOPPS, ASP, etc.
* 3+ years of professional project management experience, large and complex projects
* 3+ years of experience with regulatory and cancer specific accreditation compliance and initiatives including JCAHO, FACT, CoC, and QOPI
* 3+ years of experience working in a Managed Care plan, with an understanding of provider network contracts
* 3+ years of experience in provider practices revenue management cycle, with working knowledge of payer contracts, fee schedules, allowable tables
* Demonstrated leadership & communication skills in developing content and presenting to various specialist stakeholders
* Intermediate or higher knowledge of data analytics for healthcare
* Intermediate or higher knowledge of finance for healthcare
* Intermediate or higher level of proficiency with MS Excel, PowerPoint, Visio, and Access
* 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 a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained

Preferred Qualifications:

* MSN
* Advanced analytical and technical skills; including Tableau, Power BI, other business intelligence reporting platforms
* Solid prioritization, attention to detail, effective multi-tasking, verbal/written communication and organizational skills
* Experience creating an effective team environment, building strong relationships
* Solid in solving problems and issues in a matrix environment and communicating effectively at all levels of an organization

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

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

Colorado Residents Only: The salary range for Colorado residents is $94,500 to $171,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

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

Job Keywords: Associate Director of Clinical Practice Performance, Telecommute, Remote, Work from home