Executive Director, Medicare - TN, Telecommute

Company: UnitedHealth Group
Location: Miami
Posted on: September 25, 2022

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) The Executive Director is responsible for the management of multiple clinical programs and business development opportunities impacting Medicare Advantage populations within Tennessee helping to serve over 120,000 UHC Medicare members and 1.5M Medicare eligible in the state. The Medicare & Retirement Executive Director is accountable for all aspects of the P&L within a given market, with primary responsibility for defining, leading and driving local initiatives to achieve five Star CMS rating, Coding, Growth, Building Medicare networks, Retention of Medicare members and Affordability goals. The Executive Director sets strategy and prioritization with national shared service partners specific to the local market and ensures cross-organizational alignment. Is the face of M&R in his/her market. Establishes and maintains clear leadership credibility and partnership with our external provider and broker partners. Recruits, retains and nurtures top talent. Promotes Our United Culture. Drives innovation. Is externally focused and facing. Additionally, this role will be responsible for identifying and leading new business strategies and initiatives to meet the needs of our members. These strategies will impact Medicare Advantage product development and planning, new business ventures, and market expansion. You'll enjoy the flexibility to telecommute within Tennessee as you take on some tough challenges. Primary Responsibilities:

• Defines and owns execution of the Provider Engagement strategy; establishes strong, collaborative relationships with providers in support of all Quality, NPS and Affordability goals; works collaboratively with Optum, UHN and UCS partners
• Defines and owns execution of the Growth and Retention strategy in partnership with Distribution; is the face of the market to external channels
• Defines and owns execution of the Stars strategy inclusive of HEDIS, Part D and CAHPS to achieve 80% of members in 4+ star plans
• Stars strategy inclusive of HEDIS, Part D and CAHPs to achieve 85% of members in 4 star plans.
• Must be able to demonstrated ability of 5+ years of experience in Medicare with a concentration on Stars market leading levels at 4+ stars
• Responsible for working cross-organizationally with local health plan team, Network, Market Medical Director and Optum to increase suspect closure, recapture, and prevalence improvement inclusive of increasing HouseCalls completion rates and reducing refusal rates
• Responsible for achieving market-level NPS goals
• Responsible for identifying and executing against Affordability opportunities aligned with market goals
• Act as voice of the market for print and television interviews
• Actively collaborates with all Medicare & Retirement national functions (Product, Sales, Marketing, Member Experience, Finance), UnitedHealthcare shared services functions (Network, Clinical, Quality, Operations) and Optum (Local Care Delivery, HouseCalls, Complex Population Management) functions to leverage local market knowledge and establish and drive plans across all levers of the P&L 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. To be considered for this position, applicants need to meet the qualifications listed in this posting. Required Qualifications:
  • Bachelor's degree in business management, marketing, economics, health policy, public policy or related field or equivalent experience
  • 8+ years of experience in a large, complex and successful health care / managed care organization with demonstrated track record of increasing responsibility and accountability
  • 5+ years as a manager with direct reports who drives performance
  • Experience in Medicare provider contracting including demonstration of contracting with hospital CEOs/CFOs
  • Experience with Medicare Advantage filing of bids and creation of benefit packages that will lead to double digit growth and high member NPS scores
  • In-depth experience with health care providers/ networks, CMS Star ratings, HEDIS measures, Part D and clinical quality Preferred Qualifications:
    • Master's degree
    • Experience in a Medicare Advantage or other government-funded healthcare business
    • 5+ years of experience in Medicare provider contracting including demonstration of contracting with hospital CEOs/CFOs
    • 3+ years of proven experience with Medicare Advantage filing of bids and creation of benefit packages that will lead to double digit growth and high member NPS scores
    • Solid written and verbal communication skills, including well-developed interpersonal skills used to influence the behavior of others across a highly-matrixed organization
    • Demonstrated success building relationships with external executives and stakeholders
    • Track record of meeting business goals via driving disciplined, fact-based decisions and executing with discipline and urgency
    • Demonstrated strong financial acumen and analytical skills
    • Demonstrated excellent communication skills - ability to speak to large groups and television interviews as well
    • Proven organizational skills with ability to be flexible and work with ambiguity To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment. Careers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm) Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $113,500 to $218,100. The salary range for Connecticut / Nevada residents is $113,500 to $218,100. 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. 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.

Keywords: UnitedHealth Group, Miami , Executive Director, Medicare - TN, Telecommute, Accounting, Auditing , Miami, Florida