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Capability Manager - Value-based Risk Management - Remote

Company: UnitedHealth Group
Location: Minnetonka
Posted on: March 16, 2023

Job Description:

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 and start doing your life's best work.(sm)

The Strategic Claim and Core Capability (SCC) is a small team of professionals dedicated to solving problems, driving improved performance and leading change across all UnitedHealth Group's business segments in an objective, provocative, and accountable way. We bring substantial and diverse health care, strategic and operational consulting, business development, program management and change leadership expertise to the table. We also deliver on some of the most complex programs that require an enterprise mindset.

The SCC team partners with executives and their teams on engagements to drive meaningful change. Projects focus across a range of the Enterprise's most pressing issues, including business model transformation, service improvement, new services and products, administrative cost containment, and platform simplicity. Our team members help to resolve complex issues, identify new opportunities, and quickly drive results by applying strategic insight, intellectual honesty, and analytical structure. This approach, when joined with the deep knowledge of the business provided by segment personnel, enables a comprehensive approach to support some of the organization's most critical strategic programs impacting claim.

SCC team members can expect to be exposed to a wide variety of topics and situations across multiple segments and business functions. The environment is challenging and fast-paced, requiring flexibility in delivering against assigned tasks and ability to work in diverse areas of healthcare. Team members are expected to have a high level of energy, a passion for driving value and making a positive impact both within and beyond UnitedHealth Group, and have an ability to think in an innovative manner. Finally, SCC leaders take talent development seriously, and expect a successful tenure with the team to be a great path to even greater leadership opportunities across the UHG enterprise.

This role requires alignment to business and product strategy, effective design and development, and ongoing management of capabilities for Capitation, Claims and Incentives. You will leverage market insights to monitor trends and external landscape, and to inform capability strategies and customer use case scenarios. You will be accountable for delivering sustainable, financially sound solutions that solve a specific problem and enable successful external product delivery and/or internal business function performance, while driving adoption with internal business clients and define future capability direction that supports business strategy and new opportunities.

Value-based Risk Management includes the capabilities of capitation, claims delegation and incentives. The selected candidate will be a key leader in helping to lead the development of this capability/set of initiatives according to the Value-based Risk Management roadmap.

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

Primary Responsibilities:

  • Lead initiatives under the Value-based Risk Management program

  • Responsible for delivery of the capability/program

  • Ensure alignment and understanding of program/project scope and objectives with the organization's strategic objectives, in consultation with applicable stakeholders

  • Coordinate with SMEs to address task sequencing and to help obtain information necessary to each team

  • Facilitate and manage workgroups, enabling a culture of collaboration, trust and disciplined accomplishment of tasks and target dates

  • Establish, develop and maintain effective relationships with applicable project stakeholders including but not limited to project team members, delegated entity teams, internal customers, functional SMEs, business partners, leadership

  • Document and groom business requirements/solution capabilities for projects requiring technology changes, with ability to elicit, understand and articulate customer needs.

  • Work with Architects on solution intent

  • Acts as a resource for others; readily shares knowledge

  • Ensures operations is protected e.g. drives solutions that do not require significant adds to staffing, influences direction away from approaches and strategies that Operations cannot administer

    While you're busy helping us change the landscape of health care, you've got to be able to quickly adapt to change in a fluid environment. It's all about quality reporting, analysis and audits and developing plans and programs to support continuous quality improvement. You'll also be challenged to gain buy-in from multiple stakeholders before presenting solutions to senior leadership.

    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:

    • 4+ years of project management, business analysis and or product management experience

    • Experience working on Commercial, Medicare, Medicaid and/or Marketplace/Exchange line of business

    • Healthcare / managed care experience working in one of the following spaces: claims, eligibility, provider and/or capitation domain or related areas of work

    • Demonstrated experience with process improvement, workflow, benchmarking and / or evaluation of business processes

    • Demonstrated experience in gathering, evaluating, translating, and writing business requirements

    • Experience in supporting and collaborating system, integration, and user acceptance testing

    • Intermediate level of experience with Microsoft Office products, such as Excel or Visio

    • Experience with Agile methodology

      Preferred Qualifications:

      • Bachelor's degree in Business, Finance, Health Administration or related field required, advanced degree

      • Experienced working on RALLY Agile tool

      • Experience supporting decision-making activities by senior level business stakeholders

      • Knowledge of various Healthcare EDI transactions

      • SQL knowledge

      • Familiarity with one or more UHG claims platforms

        Competencies & Soft Skills:

        • Solid working knowledge of how to execute on project deliverables in a fast-paced environment

        • Ability to develop strong networks and ensure collaboration and consensus building

        • Ability to communicate complex issues to diverse audiences

        • Detail oriented with good sense of urgency

        • Intellectually curious

        • Bias for action

        • Flexible and adapt to priorities

          Careers with UnitedHealthcare. Work with a Fortune 5 organization that's serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

          California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York City, or Washington residents is $85,000 to $167,300. 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 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.

Keywords: UnitedHealth Group, Minnetonka , Capability Manager - Value-based Risk Management - Remote, Accounting, Auditing , Minnetonka, Minnesota

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