Remote Associate Director of Value RN, MN

Optum

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Requisition Number: 2206649
Job Category: Medical & Clinical Operations
Primary Location: Eden Prairie, MN
(Remote considered)

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

Serve as Program Director for Optum Guide Advocacy clients who are often cross carrier with a complex suite of benefits provided by multiple carriers, ancillary products, and vendors. This role will manage performance guarantees including medical trend, clinical expertise, operational turn-around times, root cause analysis and member satisfaction all critical to product performance and retention, working for the Enhanced Family Support leadership as part of Optum Guide.

This position works in collaboration with the Operation’s Management and Lead Medical Director to develop and implement action plans that achieve client outcome expectations. This role will contribute to the retention of clients by ensuring programs provides exceptional clinical value, medical cost management while improving member access and experience with their benefits. This role will consult with senior leadership and healthcare consultants to identify innovative strategies and tactics for operational excellence. Develop action plans to mitigate trend, monitor progress against plans, identify and prevent service quality issues. Develop and implement innovative clinical solutions to client-specific requirements; a clinical skill set is essential to identify and intervene appropriately to drive team and member engagement. Further, this role will ensure that programs developed are continually monitored for effectiveness and updated/revised as needed to meet objectives.

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

Primary Responsibilities: 

  • Contribute to growth and profitability of the model by ensuring the program provides exceptional clinical value and medical cost management for each individual client through identification and valuation of solutions
  • Develop and lead integrated rounds between the clinical team, Optum Rx, Briova, Behavioral Health, Clinical Coverage Review, Inpatient Care Management, specialty products and Enhanced Family Support operational leadership
  • Partner with the account management team to disseminate new solutions and best practices from across the enterprise, using a sound working knowledge of multiple functions (e.g., clinical, network, member incentive structures, provider strategies, fraud/abuse, contractual issues)

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: 

  • Registered Nurse or Healthcare Administration or Population Health  experience with 5+ years operations services delivery leadership experience
  • Demonstrated ability to lead change and innovation
  • Proven operational End to End thinker: broad program and delivery modality knowledge
  • Proven strategic operations leader: able to make decisions and drive execution
  • Proven relationship management skills: internal (staff, matrixed resources) and external (Customer, carrier, vendor)
  • Demonstrated client facing presentation skills

Preferred Qualification:         

  • Experience working with Account Management on Creative Problem Solving
  • Master-level education in related discipline (business, healthcare)

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, ConnecticutHawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $104,700 to $190,400 annually. 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.