Associate Director

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.

Positions in this function include those responsible for management and administration of multiple functions, or management of general business operations. May manage the P&L of a business or part of a business unit. Manage daily operations of multiple levels of staff and multiple functions/departments across one or more business units. May include day to day site operations, management leadership internal and external to organization, accountable for financial and non-financial results (budgets and actuals). Project management and implementation, staff management.

Primary Responsibilities:

Owns an end to end processDevelops functional, market level, and/or site strategy, plans, production and/or organizational prioritiesIdentifies and resolves technical, operational and organizational problems outside own teamProduct, service or process decisions are most likely to impact entire functions and/or customer accounts (internal or external)Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Functional Competencies

GOM_Plan/Implement/Manage Operations Programs and Strategies Utilize standard project plan templates to create and/or tailor project plans to specific customers' needsAnalyze RFP/contract language and incorporate requirements into project plansAssist internal and/or external business partners with completion of tasks and resolution of issues and problems with program implementationEstablish and/or implement internal and/or external service level agreements in order to ensure ability to monitor and measure program performance (e.g., turnaround time; quality; effectiveness)Identify and/or secure resources (e.g., funding; staffing; system security; real estate and/or telecommuting requirements; hardware/software) required to implement programsReview, create, and/or maintain workflows to ensure they are up-to-date and operationally efficientProvide guidance, expertise, and/or assistance to internal and/or external partners (e.g., claims; call center; benefits; clinical) to ensure programs and strategies are implemented and maintained effectivelyCommunicate with and help internal and/or external partners interpret contractual requirements in order to ensure effective problem solution and strategy implementation
Provide input to internal and/or external stakeholders (e.g., sales; shared business partners; pre-service vendors; facilities) in order to drive effective business plan and sales strategy development GOM_Monitor/Evaluate Operations Program and Strategy Performance Seek feedback from customers to determine success of overall project management and implementationMonitor project performance against internal and/or external service level agreementsWork with internal and/or external partners (e.g., claims; call center) to ensure accurate reports are produced to validate program performance reviewEnsure performance is tracked accurately utilizing internal tools and processes (e.g., dashboards; scorecards; reports)Request and/or receive relevant performance data from internal partners and review for accuracyManipulate provided data into applicable tools and reports in order to facilitate performance review and analysisReview consolidated operational performance reports in order to determine overall effectiveness, make necessary changes, and identify opportunities for new programs or program consolidation or expansionIncorporate operations program performance information into strategic and business planningDelegate post-implementation tasks to appropriate stakeholders to fulfill RFP/contractual agreementsAnalyze operational performance on relevant criteria (e.g., targeted financial metrics; quality indicators; performance guarantees and/or incentives) GOM_Build/Maintain/Manage Relationships with Operations Stakeholders Build and demonstrate an understanding of relevant business areas' leadership, structure, responsibilities, and work flowProvide standard performance reports (e.g., scorecards) to update relevant internal and/or external stakeholders on the status of work projectsConduct regular meetings (e.g., JOCs; QBRs) with relevant internal and/or external stakeholders to review and discuss updates and outstanding issues (e.g., project implementation readiness; compliance and/or quality audit results; out-of-compliance issues; staffing issues)Develop corrective action plans to address and/or resolve relevant internal and/or external stakeholders' concerns or issues regarding operational issuesConduct deep dive program reviews with relevant internal and/or external stakeholders to identify opportunities for continuous improvementEnsure relevant internal and/or external stakeholders (e.g., vendors; providers; leased network) are provided with correct and/or updated processes, programs, and/or policies (e.g., fee schedules)Partner with relevant internal and/or external stakeholders to develop and/or review potential operational strategies, programs, and plans (e.g., affordability initiatives; quality programs; projected resource needs) GOM_Support/Develop/Ensure Compliance with Operations Policies, Procedures, and Regulation Demonstrate understanding of and adhere to relevant policies, procedures, and regulationsStay abreast of changes and/or updates in relevant policies, procedures, and regulationsTrain and educate internal stakeholders on relevant policies and proceduresCommunicate and coordinate with and/or help internal and/or external partners interpret contractual requirements in order to ensure compliance with contractual and regulatory stipulationsProvide input into, develop, and/or modify policies and proceduresEnsure staff utilize relevant websites required in order to obtain up-to-date policies, guidelines, procedures, and regulationsTrack attendance on training for required policies, procedures, and regulationsMonitor and/or report on-going compliance and related outcomes (e.g., claim denials; complaints; clinical metrics) to relevant internal and/or external stakeholders (e.g., regulatory agencies; customers; vendors) GOM_Review/Manage/Drive Operations Efficiency, Quality, and Financial Performance Utilize stakeholder input to help shape and implement continuous improvement in operational quality and financial performance (e.g., encourage participation in Six Sigma projects)Ensure internal partners and/or external vendors adhere to business and contractual agreementsConduct end-to-end testing of applicable processes, tools, procedures, and systems platforms to validate adherence to RFP/contract requirementsEnsure that business continuity/emergency response plans are reviewed and tested regularly, up-to-date, and can be readily executedUtilize relevant systems and tools to identify and/or test opportunities for efficiency improvements (e.g., parallel variable testing)Demonstrate understanding of budgeting and forecasting tools, terminology, and processesAnalyze budget performance and variances throughout the fiscal year, and recommend and/or make necessary adjustments and correctionsWork with relevant internal partners (e.g., Finance; Underwriting) to identify resource requirements and/or create budgets and forecastsReview and assign projects/initiatives based on resource capacity, capability, and expertise

Values Based Competencies

Integrity Value: Model and Ensure Ethical Behavior Comply with Applicable Laws, Regulations and PoliciesDemonstrate IntegrityRequire Integrity and Ethical Behavior from Others Compassion Value: Deliver Value to Customers Maximize Customer Growth and RetentionOptimize the Customer Experience Relationships Value: Lead and Develop People Bring in the Right TalentDevelop PeopleDrive Employee EngagementFoster Teamwork and CollaborationLearn and Develop SelfLeverage Diversity and Inclusion Relationships Value: Communicate Effectively Communicate with ImpactInfluence and NegotiateListen ActivelyPresent Effectively Innovation Value: Lead Change and Innovation Demonstrate Emotional ResilienceImplement Innovative SolutionsManage Change Performance Value: Drive Sound, Disciplined Decisions Apply Financial KnowledgeMake Decisions to Drive Action Performance Value: Drive High-Quality Execution Communicate Clear DirectionDrive Operational ExcellenceManage Execution

Required Qualification:

Bachelor's degree in a technical field, or equivalent experience
13+ years of experience in Operations
Solid experience in Revenue Cycle Management (RCM)
Open to work in Night Shifts ( 5:30pm onwards)

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.

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