UnitedHealth Group Associate Director, Client Services - Remote in OH - Columbus in Columbus, Ohio
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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)
The purpose of this position is to support physician management objectives through participation in design, development and tactical implementation of strategic business objectives for successful retention, management and performance of assigned provider groups and pools. These initiatives should result in driving the financial viability of the market and provide a full continuum of care for the members. The Associate Director, Client Services, has management responsibility for day to day client service operations. The responsibilities of this position demand a wide range of capabilities including: strategic planning and analysis skills; solid understanding of billing and collections for physicians and or medical practices; accounting knowledge and understanding of financial statements; understanding of managed care contracts; understanding of HEDIS and coding operations; management breadth to direct and motivate; highly developed communication skills; and the ability to develop clear action plans and drive process, given often ambiguous issues with numerous interdependencies. This position will facilitate any unresolved issues that remain as a result from following the standard process. Groups reporting to this position include, but are not limited to, a team of Account Managers. This position is expected to build and sustain solid working relationships with cross functional departments within the organization in support of market goals.
If you are located in the state of OH, you will have the flexibility to work remotely* as you take on some tough challenges.
Manages account manager staff and is responsible for the overall success of the market’s network of contracted provider groups
Analyze provider group pool performance to determine areas of focus or improvement opportunities, to include performing complex analysis of financial statements and other metric-related report to forecast and plan resource and business plan requirements
Develops strategies, and create action plans that align provider pools and groups with company initiatives, goals (revenue and expense) and quality outcomes
Drive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics, coding and documentation process and educational improvements
Use and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues
Assists assigned account managers and acts as lead with coordinating, planning, implementing Joint Operating Committee meetings with assigned provider pools, as needed. Develops and coaches staff to facilitate strategic business meetings with physician groups and their staff
Aspects of staff development to include hiring, training, coaching and development. Guides, oversees and ensures competency of the assigned Account Manager staff
Maximizes staff performance and technical expertise through clearly defined objectives, training, skill development and leadership to ensure quality services to all customers
Delegate, monitor and control work progress on key metrics, initiatives/action plans, staff productivity, and administrative expenses
Participates in development and implementation of systems that support Client Operations
Maintains effective support services by working effectively with the Director of Client Services, Regional Medical Director, Clinical Services team, Operations and other corporate departments
Handles complex and/or difficult provider inquires and/or problems and facilitates resolution of provider issues. Continuously strive to ensure that favorable relationships are maintained while ensuring the interest of the organization
Takes ownership of total work process and provides constructive information to ensure physician partners have support to meet initiatives
Demonstrate understanding of providers' business goals and strategies in order to facilitate the analysis and resolution of their issues
Work with relevant internal stakeholders to identify obstacles and barriers identified by providers, and methods for removing them
Communicate and advocate providers' needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals
Communicate industry and company information to providers through various means (e.g., newsletters; emails; outreach calls; teleconference; conferences; on-site meetings)
Assist Client Services education team and provides input on tools used to educate Account Manager team
Ensures all education objectives are being met, both on a formal and ad-hoc basis
Responsible for ensuring the assigned account manager team is responding to provider inquiries and resolving provider issues on a daily basis. Facilitates provider discussions and assists in negotiating resolution to escalated provider issues with the capability to determine if/when issues require escalation.
Collectively works with Clinical Services team to create, maintain, implement and evaluate business strategic plans that positively impact total medical costs
Works closely with Clinical Services care management, coding, and quality teams to attain metric targets by collaboratively creating, maintaining, implementing and evaluating business strategic plans for each area
Provides overall direction and responsibility, in collaboration with Market Client Service Director, in creation of the overall strategic plan, training of the account managers to carry out the strategic plan, as well as overall implementation of new primary care provider groups., where necessary
Understands payer relationships within market and ensures any operational issues are visible to the appropriate parties and ensures issue resolution
Performs 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.
Bachelor’s degree in Business Administration, Marketing, Healthcare Administration or a related field required (4+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree)
5+ years of related experience in network development/provider relations with at least 2 years with management experience
Solid working knowledge of Medicare health care operations including HEDIS, HCC Coding and Medicare Advantage
Knowledge of state and federal laws relating to Medicare
Ability and willingness to travel, both locally and non-locally, as determined by business need
Master’s degree in Business Administration, Marketing, Healthcare Administration or a related field required.
5+ years of in a healthcare related field
3+ years of Healthcare management experience
Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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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