At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Director ASO Program Operations is contractually required per the ASO SOW as listed in Exhibit A, section 3C, and shall serve as RMHP's primary point of contact for NHP. Supports corporate objectives by developing, maintaining and utilizing expert knowledge of Government Programs, including operations as a Medicaid Regional Accountable Entity (RAE). Provides expertise, leadership, and oversight to support NHP operations for ACC3.0 Medicaid state program activities and initiatives, including health plan operations that affect customer service, enrollment, IT, reporting, provider contracting, provider relations, vendor contracting, performance guarantees, and clinical operations. Prepares RMHP operations for RAE Region 2 growing government programs membership. Provides project management support for new and expansion activities. Lead and participate in JOS team meetings with Executive Leadership of NHP as well as RMHP. Develops and prepares monthly status reports of all contractually required ASO services. Accountable for meeting Medicaid ACC3.0 performance guarantees as well as ASO contractual performance guarantees. If you reside in Colorado, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities:
- Works collaboratively with the Chief Operating officer and all health plan Executive leadership and in accordance with the Mission and Values of the company to assist in maintaining and enhancing RMHP's reputation as the leader in Medicaid managed health care. Provides leadership by example to embed the organizational philosophy and culture
- Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
- Directly accountable for managing day to day operations of the ASO contract and direct oversight of the company's Medicaid RAE Region 2 ASO agreement
- Directs, plans, communicates, anticipates, facilitates, and manages the implementation of new requirements for Medicaid RAE Region 2 both at the health plan and at the enterprise. Communicates internally all changes and new requirements for ASO expansion activities
- Provides project management and support for new and expansion activities, including anticipating, identifying, and addressing the challenges of integration with systems and vendor contracts
- Anticipates potential contractual misses through thought leadership and observation of health plan and enterprise performance. Reporting status to Sr. Leadership directly and as needed
- Provides education to RMHP, COPA, and enterprise operations staff regarding ASO SOW changes that are either impacted directly by ASO updates or ACC3.0 contractual updates that impacts the services of the ASO SOW
- Develops and maintains effective interactions with all levels of the RMHP and NHP operations and Executive Leadership teams
- Effectively manages and balances a variety of projects and competing priorities
- Works with Community Integration Director to strategically plan for Medicaid RAE ACC3.0, ensuring the RAE Regions are in sync at the health plan and the enterprise at all times
- Provides thought leadership for new initiatives and major projects for enhancements
- Identifies opportunities for growth, sustainability, affordability, and efficiency in Medicaid RAE Region 2. Establishes direction and planning for initiatives to achieve these goals
- Maintains stakeholder intelligence and assists with the organization, writing and submission of RFP and grant opportunities for Medicaid and low-income populations that are supported by RMHP and NHP Leadership supporting RAE Region 2 activities
- Supports joint quality and payment incentive projects agreed by RMHP, NHP, and HCPF, and or other RMHP partners, working with and assisting the Community Integration Director in the internal management of multiple stakeholder relationships and the production of associated deliverables
- Coordinates the production of actuarial and financial modeling, analysis and presentation materials as necessary to assess and respond to challenges and opportunities in Medicaid RAE Region 2
- Develops, oversees, and ensures that filings, reports and billings for Medicaid RAE Region 2 are made accurately and on a timely basis meeting contractual obligation turnaround time
- Monitors and ensures responsiveness and compliance with government contracts, directives and laws that govern Medicaid RAE and government programs activities
- Provides thought leadership and oversight to quality improvement initiatives for the RAE
- Manage staff members who also support the ASO RAE Region 2 contract Select, train, develop, appraise, and motivate qualified staff to effectively carry out ASO services functions
- Appropriately train, mentor, and support staff Take corrective action as necessary on a timely basis and in accordance with company policy. Consult with COO and HR as appropriate
- Work proactively with other departments both at the enterprise as well as the health plan, to ensure processes and staff are aligned to provide excellent and efficient ASO services support
- Provide effective communication within the department and with other internal and external departments, Senior Leadership, and State Agencies
- This position requires travel Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage
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:
- Bachelor's degree in health care policy, business, public health, or the combination of education and experience that would enable performance of the full scope of the position
- Experience with and knowledge of principles of local, state, and federal government operations
- Demonstrated ability to communicate effectively at all levels with an organization and to manage and balance multiple projects and competing priorities
- Driver's License and access to a reliable transportation
Preferred Qualification:
- 5+ years of progressive experience designing and providing training in health care management, project management, regulatory compliance and advanced knowledge of health care and health coverage issues and regulations
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy The salary range for this role is $106,800 to $194,200 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. 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. 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.
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